CAROLYN MARIE KELLY DPM Podiatrist License verification

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000752

License Status

EXPIRED

Business

Title

DPM

First Name

CAROLYN

Middle

MARIE

Last Name

KELLY

Business Name

CAROLYN MARIE KELLY DPM

Original Issue Date

07/05/2011

Effective Date

07/05/2011

Expiration Date

06/30/2012

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

08/29/2012