KEITH WILLIAM ROACH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125024718

License Status

EXPIRED

Business

First Name

KEITH WILLIAM

Last Name

ROACH

Suffix

Business Name

KEITH WILLIAM ROACH MD

Original Issue Date

05/03/1990

Effective Date

05/03/1990

Expiration Date

06/23/1993

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006