ELIZABETH PHILLIPS KELLEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****44

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Middle

PHILLIPS

Last Name

KELLEY

Business Name

ELIZABETH PHILLIPS KELLEY

Original Issue Date

01/29/2004

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

ADDISON

State

Zip

60101

County

DUPAGE

Ever Disciplined

LastModifiedDate

07/29/2015