KEITH A JOHNSON Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125013406

License Status

EXPIRED

Business

First Name

KEITH

Middle

Last Name

JOHNSON

Business Name

KEITH A JOHNSON

Original Issue Date

07/24/1981

Effective Date

07/24/1981

Expiration Date

06/24/1983

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006