KELLEY K STALEY Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

ACTIVE

Business

First Name

KELLEY

Middle

Last Name

STALEY

Business Name

KELLEY K STALEY

Original Issue Date

06/12/2006

Effective Date

07/18/2023

Expiration Date

07/31/2026

City

OAK PARK

State

Zip

60304

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/18/2023