KELLY LAINE EATON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057840

License Status

CANCELLED

Business

Title

First Name

KELLY

Middle

LAINE

Last Name

EATON

Business Name

KELLY LAINE EATON MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2013

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

05/18/2010