KELLY E JOHNSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

ACTIVE

Business

First Name

KELLY E

Last Name

JOHNSON

Suffix

Business Name

KELLY E JOHNSON MD

Original Issue Date

07/23/1992

Effective Date

07/23/2023

Expiration Date

07/31/2026

City

ST LOUIS

State

Zip

63103

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/23/2023