KELLY LAINE EATON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036131774

License Status

NOT RENEWED

Business

Title

First Name

KELLY

Middle

LAINE

Last Name

EATON

Business Name

KELLY LAINE EATON MD

Original Issue Date

11/28/2012

Effective Date

11/28/2012

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014