KELLEY ELIZABETH KOZMA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052417

License Status

CANCELLED

Business

First Name

KELLEY

Middle

ELIZABETH

Last Name

KOZMA

Suffix

Business Name

KELLEY ELIZABETH KOZMA DO

Original Issue Date

06/24/2007

Effective Date

06/24/2007

Expiration Date

06/23/2010

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/01/2007