STEPHEN MICHAEL KELLY DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036155914

License Status

ACTIVE

Business

Title

First Name

STEPHEN

Middle

MICHAEL

Last Name

KELLY

Business Name

STEPHEN MICHAEL KELLY DO

Original Issue Date

03/05/2021

Effective Date

06/14/2023

Expiration Date

07/31/2026

City

MAPLEWOOD

State

Zip

07040

Ever Disciplined

LastModifiedDate

06/02/2025