KEITH R FISH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

ACTIVE

Business

First Name

KEITH

Middle

Last Name

FISH

Suffix

Business Name

KEITH R FISH MD

Original Issue Date

08/10/2022

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60625

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023