KELLY MARIE LOGAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

ACTIVE

Business

Title

First Name

KELLY

Middle

MARIE

Last Name

LOGAN

Business Name

KELLY MARIE LOGAN MD

Original Issue Date

02/11/2015

Effective Date

04/21/2023

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

04/21/2023