KATHERINE MARIE KELLEY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

ACTIVE

Business

Title

First Name

KATHERINE

Middle

MARIE

Last Name

KELLEY

Business Name

KATHERINE MARIE KELLEY MD

Original Issue Date

06/25/2020

Effective Date

08/22/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62902

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/22/2023