KAY PONTIUS KELLY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

First Name

KAY PONTIUS

Last Name

KELLY

Business Name

KAY PONTIUS KELLY

Original Issue Date

01/01/1997

Effective Date

05/03/2017

Expiration Date

09/30/2020

City

DARIEN

State

Zip

60561

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021