ANTHONY KELLY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****35

License Status

NOT RENEWED

Business

First Name

ANTHONY

Last Name

KELLY

Business Name

ANTHONY KELLY

Original Issue Date

05/25/2006

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

12/01/2010