JASON ALEXANDER KELLY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046000

License Status

EXPIRED

Business

First Name

JASON

Middle

ALEXANDER

Last Name

KELLY

Suffix

Business Name

JASON ALEXANDER KELLY MD

Original Issue Date

07/01/2003

Effective Date

07/01/2003

Expiration Date

06/30/2006

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006