BRIAN MATTHEW KELLY DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102770

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

MATTHEW

Last Name

KELLY

Suffix

Business Name

BRIAN MATTHEW KELLY DO

Original Issue Date

06/21/2000

Effective Date

06/21/2000

Expiration Date

07/31/2005

City

WHEATON

State

Zip

60187

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/09/2006