TIMOTHY KELLEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001277

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Last Name

KELLEY

Business Name

TIMOTHY KELLEY

Original Issue Date

12/23/1999

Effective Date

12/23/1999

Expiration Date

03/01/2008

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

04/23/2008