MICHAEL J KELLUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

First Name

MICHAEL J

Last Name

KELLUM

Suffix

Business Name

MICHAEL J KELLUM MD

Original Issue Date

07/11/1984

Effective Date

07/11/1984

Expiration Date

07/31/1996

City

JOLIET

State

Zip

60432

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011