KEITH JOHN BUTVILAS DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036659

License Status

EXPIRED

Business

First Name

KEITH

Middle

JOHN

Last Name

BUTVILAS

Suffix

Business Name

KEITH JOHN BUTVILAS DO

Original Issue Date

06/12/1997

Effective Date

06/12/1997

Expiration Date

06/19/2000

City

OLYMPIA FLDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006