KELLEY J STANLEY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044078

License Status

CANCELLED

Business

Title

First Name

KELLEY J

Last Name

STANLEY

Business Name

KELLEY J STANLEY MD

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2005

City

LA GRANGE

State

Zip

60525

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006