KELLY J BOOKMAN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036094104

License Status

NOT RENEWED

Business

First Name

KELLY J

Last Name

BOOKMAN

Business Name

KELLY J BOOKMAN

Original Issue Date

08/26/1996

Effective Date

08/26/1996

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60605

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006