MICHAEL PATRICK KELLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

PATRICK

Last Name

KELLEY

Suffix

Business Name

MICHAEL PATRICK KELLEY MD

Original Issue Date

07/08/2003

Effective Date

08/02/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021