KELLEY FORD SHIPPEY III MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

ACTIVE

Business

Title

First Name

KELLEY

Middle

FORD

Last Name

SHIPPEY III

Business Name

KELLEY FORD SHIPPEY III MD

Original Issue Date

07/21/2023

Effective Date

07/21/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/21/2023