KELLY C PENG DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

ACTIVE

Business

Title

First Name

KELLY

Middle

Last Name

PENG

Business Name

KELLY C PENG DO

Original Issue Date

02/06/2024

Effective Date

02/06/2024

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/06/2024