REBECCA I KELLUM Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

First Name

REBECCA

Middle

Last Name

KELLUM

Business Name

REBECCA I KELLUM

Original Issue Date

05/22/2008

Effective Date

05/19/2011

Expiration Date

07/31/2014

City

BILLINGS

State

Zip

59106

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014