KEITH P MINIHANE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

First Name

KEITH

Middle

Last Name

MINIHANE

Suffix

Business Name

KEITH P MINIHANE MD

Original Issue Date

06/27/2003

Effective Date

06/22/2011

Expiration Date

07/31/2014

City

MENDOTA

State

Zip

61342

County

LA SALLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014