MICHAEL PATRICK KELLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036109646

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

PATRICK

Last Name

KELLEY

Suffix

Business Name

MICHAEL PATRICK KELLEY MD

Original Issue Date

07/07/2003

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021