KELLY MARIE MILLER DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055975

License Status

EXPIRED

Business

First Name

KELLY

Middle

MARIE

Last Name

MILLER

Suffix

Business Name

KELLY MARIE MILLER DO

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

LA GRANGE

State

Zip

60525

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

08/29/2012