KEITH T KUSUNIS Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125014931

License Status

EXPIRED

Business

First Name

KEITH

Middle

Last Name

KUSUNIS

Business Name

KEITH T KUSUNIS

Original Issue Date

08/23/1982

Effective Date

08/23/1982

Expiration Date

07/01/1984

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006