KELLEY LORRAINE MINISH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

NOT RENEWED

Business

First Name

KELLEY LORRAINE

Last Name

MINISH

Suffix

Business Name

KELLEY LORRAINE MINISH MD

Original Issue Date

12/18/1996

Effective Date

12/18/1996

Expiration Date

07/31/2005

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006