KELLY L DEBOER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

Title

First Name

KELLY

Middle

Last Name

DEBOER

Business Name

KELLY L DEBOER MD

Original Issue Date

10/11/2011

Effective Date

06/12/2020

Expiration Date

07/31/2023

City

OGLESBY

State

Zip

61348

County

LA SALLE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023