KELLY V BOMER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102505

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

BOMER

Business Name

KELLY V BOMER

Original Issue Date

05/18/2000

Effective Date

05/18/2000

Expiration Date

07/31/2002

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006