KELLY ROSE PHILLIPS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068515

License Status

EXPIRED

Business

Title

First Name

KELLY

Middle

ROSE

Last Name

PHILLIPS

Business Name

KELLY ROSE PHILLIPS MD

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2019

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/02/2019