DANIEL J KELLY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

NOT RENEWED

Business

First Name

DANIEL J

Last Name

KELLY

Suffix

Business Name

DANIEL J KELLY MD

Original Issue Date

11/02/1981

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

LAKE FOREST

State

Zip

60045

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021