KELLY MARIE KLOTZ MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069264

License Status

EXPIRED

Business

Title

First Name

KELLY

Middle

MARIE

Last Name

KLOTZ

Business Name

KELLY MARIE KLOTZ MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2020

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

LastModifiedDate

11/19/2020