CARLY ELIZABETH KELLEHER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****54

License Status

ACTIVE

Business

First Name

CARLY

Middle

ELIZABETH

Last Name

KELLEHER

Business Name

CARLY ELIZABETH KELLEHER

Original Issue Date

08/21/2023

Effective Date

01/23/2026

Expiration Date

03/01/2028

City

CREST HILL

State

Zip

60403

County

WILL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/23/2026