MARY ELIZABETH KELLER 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

MARY

Middle

ELIZABETH

Last Name

KELLER

Suffix

Business Name

MARY ELIZABETH KELLER MD

Original Issue Date

08/10/2005

Effective Date

05/27/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/27/2023