TANIA L KELLY Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112183

License Status

INACTIVE

Business

First Name

TANIA

Middle

Last Name

KELLY

Business Name

TANIA L KELLY

Original Issue Date

08/23/2004

Effective Date

06/08/2011

Expiration Date

07/31/2014

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

07/30/2014