KEITH C ANDERSON DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125020743

License Status

EXPIRED

Business

First Name

KEITH C

Last Name

ANDERSON

Suffix

Business Name

KEITH C ANDERSON DO

Original Issue Date

05/08/1987

Effective Date

05/08/1987

Expiration Date

07/01/1990

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006