KELLY KATHERYN MACKIE DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056519

License Status

CANCELLED

Business

Title

First Name

KELLY

Middle

KATHERYN

Last Name

MACKIE

Business Name

KELLY KATHERYN MACKIE DO

Original Issue Date

06/22/2009

Effective Date

06/22/2009

Expiration Date

06/21/2012

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/02/2009