KELLEY ALANE VIDULICH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050113

License Status

EXPIRED

Business

First Name

KELLEY

Middle

ALANE

Last Name

VIDULICH

Suffix

Business Name

KELLEY ALANE VIDULICH MD

Original Issue Date

06/15/2005

Effective Date

06/15/2005

Expiration Date

06/14/2006

City

BERWYN

State

Zip

60402

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006