JAMES WILLIAM KELLERSHABROKH DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056332

License Status

CANCELLED

Business

Title

First Name

JAMES

Middle

WILLIAM

Last Name

KELLERSHABROKH

Business Name

JAMES WILLIAM KELLERSHABROKH DO

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2013

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Physical Medicine and Rehabilitation

Ever Disciplined

LastModifiedDate

06/18/2012