TANIA L KELLY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

TANIA

Middle

Last Name

KELLY

Business Name

TANIA L KELLY

Original Issue Date

02/08/2005

Effective Date

06/08/2011

Expiration Date

07/31/2014

City

OAK LAWN

State

Zip

60453

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014