MARK JOHN KELLY 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

MARK JOHN

Last Name

KELLY

Business Name

MARK JOHN KELLY

Original Issue Date

07/06/1998

Effective Date

06/11/2023

Expiration Date

07/31/2026

City

WINFIELD

State

Zip

60190

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/11/2023