KELLEY R SMITH DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039393

License Status

EXPIRED

Business

First Name

KELLEY

Middle

Last Name

SMITH

Suffix

Business Name

KELLEY R SMITH DO

Original Issue Date

06/21/1999

Effective Date

06/21/1999

Expiration Date

06/20/2002

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006