CASEY SMITH KELLEY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053132

License Status

CANCELLED

Business

Title

First Name

CASEY

Middle

SMITH

Last Name

KELLEY

Business Name

CASEY SMITH KELLEY MD

Original Issue Date

06/20/2007

Effective Date

06/20/2007

Expiration Date

06/19/2010

City

CHICAGO

State

Zip

60607

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/25/2007