PHILIP DOUGLAS KELLEY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027841

License Status

EXPIRED

Business

First Name

PHILIP

Middle

DOUGLAS

Last Name

KELLEY

Suffix

Business Name

PHILIP DOUGLAS KELLEY MD

Original Issue Date

05/04/1992

Effective Date

05/04/1992

Expiration Date

06/25/1995

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006