KEITH J MOLL MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036078144

License Status

INACTIVE

Business

First Name

KEITH J

Last Name

MOLL

Suffix

Business Name

KEITH J MOLL MD

Original Issue Date

11/16/1988

Effective Date

11/16/1988

Expiration Date

07/31/1990

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006