MARK W KELLER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125015984

License Status

EXPIRED

Business

First Name

MARK W

Last Name

KELLER

Suffix

Business Name

MARK W KELLER MD

Original Issue Date

06/15/1983

Effective Date

06/15/1983

Expiration Date

06/25/1985

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006