MICHAEL KEITH SALLEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036060713

License Status

NOT RENEWED

Business

First Name

MICHAEL KEITH

Last Name

SALLEN

Suffix

Business Name

MICHAEL KEITH SALLEN MD

Original Issue Date

08/04/1980

Effective Date

08/04/1980

Expiration Date

07/31/1984

City

HIGHLAND PARK

State

Zip

60035

County

LAKE

Ever Disciplined

LastModifiedDate

09/20/2006