MARK LOREN KELDAHL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

ACTIVE

Business

First Name

MARK

Middle

LOREN

Last Name

KELDAHL

Suffix

Business Name

MARK LOREN KELDAHL MD

Original Issue Date

12/12/2006

Effective Date

04/10/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/10/2023