KEITH R WALLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036068821

License Status

NOT RENEWED

Business

First Name

KEITH R

Last Name

WALLEY

Suffix

Business Name

KEITH R WALLEY MD

Original Issue Date

06/14/1984

Effective Date

06/14/1984

Expiration Date

07/31/1990

City

LISLE

State

Zip

60532

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006