MARK A KELLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

NOT RENEWED

Business

First Name

MARK A

Last Name

KELLEY

Suffix

Business Name

MARK A KELLEY MD

Original Issue Date

04/20/1992

Effective Date

09/25/2008

Expiration Date

07/31/2011

City

PERU

State

Zip

61354

County

LA SALLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017