KELLY MARIE MAXWELL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045699

License Status

EXPIRED

Business

First Name

KELLY

Middle

MARIE

Last Name

MAXWELL

Suffix

Business Name

KELLY MARIE MAXWELL MD

Original Issue Date

04/28/2003

Effective Date

04/28/2003

Expiration Date

06/16/2009

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

07/15/2009