TIMOTHY L KELLY Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036105906

License Status

INACTIVE

Business

First Name

TIMOTHY

Middle

Last Name

KELLY

Business Name

TIMOTHY L KELLY

Original Issue Date

11/28/2001

Effective Date

11/28/2001

Expiration Date

07/31/2002

City

GRESHAM

State

Zip

97080

County

OREGON

Ever Disciplined

LastModifiedDate

10/09/2006