KELLY MEAD GAUGHEN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

Title

First Name

KELLY

Middle

MEAD

Last Name

GAUGHEN

Business Name

KELLY MEAD GAUGHEN DO

Original Issue Date

02/18/2015

Effective Date

02/18/2015

Expiration Date

07/31/2017

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017