KERRY ANNE LECKY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

Title

First Name

KERRY

Middle

ANNE

Last Name

LECKY

Business Name

KERRY ANNE LECKY MD

Original Issue Date

12/19/2018

Effective Date

12/19/2018

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021