JEANNETTE SUZANNE CODERE KELLY DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

ACTIVE

Business

First Name

JEANNETTE

Middle

SUZANNE CODERE

Last Name

KELLY

Suffix

Business Name

JEANNETTE SUZANNE CODERE KELLY DO

Original Issue Date

04/08/2016

Effective Date

06/24/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60618

County

MICHIGAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/24/2023