KELLY ANN KENNELL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057388

License Status

CANCELLED

Business

Title

First Name

KELLY

Middle

ANN

Last Name

KENNELL

Business Name

KELLY ANN KENNELL MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2015

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

03/24/2014