KELLY A MARTENS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052807

License Status

CANCELLED

Business

Title

First Name

KELLY

Middle

Last Name

MARTENS

Business Name

KELLY A MARTENS MD

Original Issue Date

06/18/2010

Effective Date

06/18/2010

Expiration Date

06/17/2012

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

02/04/2010