KELLY V BOMER Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032858

License Status

EXPIRED

Business

First Name

KELLY

Middle

Last Name

BOMER

Business Name

KELLY V BOMER

Original Issue Date

05/30/1995

Effective Date

05/30/1995

Expiration Date

06/23/2000

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

09/22/2006