KELLEY J STANLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

NOT RENEWED

Business

Title

First Name

KELLEY J

Last Name

STANLEY

Business Name

KELLEY J STANLEY MD

Original Issue Date

11/29/2004

Effective Date

11/29/2004

Expiration Date

07/31/2005

City

LA GRANGE

State

Zip

60525

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020