BRIAN MATTHEW KELLY DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036053

License Status

EXPIRED

Business

First Name

BRIAN

Middle

MATTHEW

Last Name

KELLY

Suffix

Business Name

BRIAN MATTHEW KELLY DO

Original Issue Date

05/14/1997

Effective Date

05/14/1997

Expiration Date

06/30/2000

City

CHICAGOP

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006