KELLEY D KENNEDY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

NOT RENEWED

Business

First Name

KELLEY D

Last Name

KENNEDY

Suffix

Business Name

KELLEY D KENNEDY MD

Original Issue Date

06/21/1990

Effective Date

04/12/2011

Expiration Date

07/31/2014

City

NORMAL

State

Zip

61761

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020