MARYANN LILA KELLY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

ACTIVE

Business

Title

First Name

MARYANN

Middle

LILA

Last Name

KELLY

Business Name

MARYANN LILA KELLY MD

Original Issue Date

11/13/2020

Effective Date

06/07/2023

Expiration Date

07/31/2026

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/07/2023