KELLY L SIUDZINSKI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

CANCELLED

Business

First Name

KELLY

Middle

Last Name

SIUDZINSKI

Suffix

Business Name

KELLY L SIUDZINSKI MD

Original Issue Date

04/21/2005

Effective Date

04/21/2005

Expiration Date

07/31/2008

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006