ANTHONY KELLY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002699

License Status

NOT RENEWED

Business

First Name

ANTHONY

Last Name

KELLY

Business Name

ANTHONY KELLY

Original Issue Date

03/21/2006

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

12/01/2010