COLETTE MARIE KELLY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008635

License Status

NOT RENEWED

Business

First Name

COLETTE

Middle

MARIE

Last Name

KELLY

Business Name

COLETTE MARIE KELLY

Original Issue Date

09/29/2021

Effective Date

09/29/2021

Expiration Date

03/01/2022

City

LEMONT

State

Zip

60439

County

COOK

Ever Disciplined

LastModifiedDate

07/27/2022