KEITH WILLIAM ROACH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036086570

License Status

NOT RENEWED

Business

First Name

KEITH WILLIAM

Last Name

ROACH

Suffix

Business Name

KEITH WILLIAM ROACH MD

Original Issue Date

06/22/1993

Effective Date

06/22/1993

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006