KELLY ANNE KLOCEK DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036158033

License Status

ACTIVE

Business

Title

First Name

KELLY

Middle

ANNE

Last Name

KLOCEK

Business Name

KELLY ANNE KLOCEK DO

Original Issue Date

08/16/2021

Effective Date

07/06/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61104

Ever Disciplined

LastModifiedDate

07/06/2023