KELLY ELISE BLAIR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075895

License Status

CANCELLED

Business

Title

First Name

KELLY

Middle

ELISE

Last Name

BLAIR

Business Name

KELLY ELISE BLAIR MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2023

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

05/21/2020