JUSTIN KELLEY SPACKEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

NOT RENEWED

Business

First Name

JUSTIN

Middle

KELLEY

Last Name

SPACKEY

Suffix

Business Name

JUSTIN KELLEY SPACKEY MD

Original Issue Date

04/13/2009

Effective Date

06/09/2011

Expiration Date

07/31/2014

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020