KELLY MARIE LIESSE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036152067

License Status

NOT RENEWED

Business

Title

First Name

KELLY

Middle

MARIE

Last Name

LIESSE

Business Name

KELLY MARIE LIESSE MD

Original Issue Date

03/05/2020

Effective Date

07/09/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/30/2023