DAVID M KELLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

DAVID M

Last Name

KELLER

Suffix

Business Name

DAVID M KELLER MD

Original Issue Date

03/10/1986

Effective Date

03/10/1986

Expiration Date

07/31/1990

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006