KELLEY J STANLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

Title

First Name

KELLEY J

Last Name

STANLEY

Business Name

KELLEY J STANLEY MD

Original Issue Date

05/28/2019

Effective Date

05/28/2019

Expiration Date

09/30/2020

City

MORRISON

State

Zip

61270

County

WHITESIDE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021