MICHAEL RANDALL KELLER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036094478

License Status

NOT RENEWED

Business

First Name

MICHAEL RANDALL

Last Name

KELLER

Business Name

MICHAEL RANDALL KELLER

Original Issue Date

11/02/1996

Effective Date

11/02/1996

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60656

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006