NICOLE CHRISTINE KELLER DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056701

License Status

CANCELLED

Business

Title

First Name

NICOLE

Middle

CHRISTINE

Last Name

KELLER

Business Name

NICOLE CHRISTINE KELLER DO

Original Issue Date

06/25/2009

Effective Date

06/25/2009

Expiration Date

06/24/2012

City

OSWEGO

State

Zip

60543

County

KENDALL

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

04/15/2009