KEITH J MOLL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125021279

License Status

EXPIRED

Business

First Name

KEITH J

Last Name

MOLL

Suffix

Business Name

KEITH J MOLL MD

Original Issue Date

06/11/1987

Effective Date

06/11/1987

Expiration Date

06/22/1990

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006