MARK W KELLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036069494

License Status

NOT RENEWED

Business

First Name

MARK W

Last Name

KELLER

Suffix

Business Name

MARK W KELLER MD

Original Issue Date

09/18/1984

Effective Date

09/18/1984

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006