ANISA FATIMA KELLEY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

ACTIVE

Business

Title

First Name

ANISA

Middle

FATIMA

Last Name

KELLEY

Business Name

ANISA FATIMA KELLEY MD

Original Issue Date

06/25/2019

Effective Date

04/05/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023