License Type:
Medical Doctor
License Number:
4301116979
Name:
Matthew Edmund Kelly
License Issue Date:
02/07/2019
License Expiration Date:
02/07/2029
License Status:
Active
County:
Kalamazoo
City:
State or Province:
Michigan
ZIP or Postal Code:
49008
CS Record Number:
5315204079
CS Status:
CS Expiration Date:
5315075638
Lapsed
06/30/2019