KEITH DAVID CLANCY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027678

License Status

EXPIRED

Business

First Name

KEITH

Middle

DAVID

Last Name

CLANCY

Suffix

Business Name

KEITH DAVID CLANCY MD

Original Issue Date

04/21/1992

Effective Date

04/21/1992

Expiration Date

07/30/1995

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006