KELLY ANNE KLOCEK DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

ACTIVE

Business

Title

First Name

KELLY

Middle

ANNE

Last Name

KLOCEK

Business Name

KELLY ANNE KLOCEK DO

Original Issue Date

09/01/2021

Effective Date

07/06/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61104

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/06/2023