MICHAEL J KELLUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036068853

License Status

NOT RENEWED

Business

First Name

MICHAEL J

Last Name

KELLUM

Suffix

Business Name

MICHAEL J KELLUM MD

Original Issue Date

06/18/1984

Effective Date

05/18/2011

Expiration Date

07/31/2014

City

LAKE GENEVA

State

Zip

53147

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/17/2014