TIMOTHY MICHAEL KETTERHAGEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

ACTIVE

Business

Title

First Name

TIMOTHY

Middle

MICHAEL

Last Name

KETTERHAGEN

Business Name

TIMOTHY MICHAEL KETTERHAGEN MD

Original Issue Date

02/19/2015

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/19/2023