KEITH W GREEN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125018976

License Status

EXPIRED

Business

First Name

KEITH W

Last Name

GREEN

Business Name

KEITH W GREEN

Original Issue Date

08/14/1985

Effective Date

08/14/1985

Expiration Date

07/01/1988

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006