LANEA MARIE MARCELLE KELLER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054513

License Status

EXPIRED

Business

Title

First Name

LANEA

Middle

MARIE MARCELLE

Last Name

KELLER

Business Name

LANEA MARIE MARCELLE KELLER MD

Original Issue Date

06/23/2008

Effective Date

06/23/2008

Expiration Date

06/22/2009

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Transitional Year

Ever Disciplined

LastModifiedDate

07/15/2009