KELLY CARLSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036151894

License Status

NOT RENEWED

Business

Title

First Name

KELLY

Last Name

CARLSON

Business Name

KELLY CARLSON MD

Original Issue Date

02/20/2020

Effective Date

08/11/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60631

County

COOK

Ever Disciplined

LastModifiedDate

11/30/2023