CHARLES E KELLY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

CANCELLED

Business

First Name

CHARLES E

Last Name

KELLY

Suffix

Business Name

CHARLES E KELLY MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1990

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006