FREDERICK JAY KELLAWAY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036109587

License Status

NOT RENEWED

Business

First Name

FREDERICK

Middle

JAY

Last Name

KELLAWAY

Suffix

Business Name

FREDERICK JAY KELLAWAY MD

Original Issue Date

06/30/2003

Effective Date

07/11/2014

Expiration Date

07/31/2017

City

FENNVILLE

State

Zip

49408

County

MICHIGAN

Ever Disciplined

LastModifiedDate

11/01/2017