KELLY M FARROLL Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030799

License Status

EXPIRED

Business

First Name

KELLY M

Last Name

FARROLL

Business Name

KELLY M FARROLL

Original Issue Date

01/05/1994

Effective Date

01/05/1994

Expiration Date

01/03/1997

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006