KYLE BLAINE KELLY Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125081707

License Status

ACTIVE

Business

First Name

KYLE

Middle

BLAINE

Last Name

KELLY

Business Name

KYLE BLAINE KELLY

Original Issue Date

06/24/2023

Effective Date

06/24/2023

Expiration Date

06/23/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

05/08/2023