MARK LOREN KELDAHL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047613

License Status

EXPIRED

Business

First Name

MARK

Middle

LOREN

Last Name

KELDAHL

Suffix

Business Name

MARK LOREN KELDAHL MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

07/03/2007