KELLY E JOHNSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

First Name

KELLY E

Last Name

JOHNSON

Suffix

Business Name

KELLY E JOHNSON MD

Original Issue Date

07/23/1992

Effective Date

07/23/1992

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60601

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020