KATHLEEN M KELLY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

ACTIVE

Business

First Name

KATHLEEN M

Last Name

KELLY

Suffix

Business Name

KATHLEEN M KELLY MD

Original Issue Date

01/07/2025

Effective Date

01/07/2025

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/07/2025