LISA D KELLY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

NOT RENEWED

Business

First Name

LISA D

Last Name

KELLY

Suffix

Business Name

LISA D KELLY MD

Original Issue Date

09/10/1990

Effective Date

09/10/1990

Expiration Date

07/31/1993

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006