KELLY L HARTEL Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

KELLY L

Last Name

HARTEL

Business Name

KELLY L HARTEL

Original Issue Date

06/24/1996

Effective Date

06/24/1996

Expiration Date

07/31/1999

City

DECATUR

State

Zip

62526

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006