KEITH RICHARD SARPOLIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

ACTIVE

Business

First Name

KEITH RICHARD

Last Name

SARPOLIS

Suffix

Business Name

KEITH RICHARD SARPOLIS MD

Original Issue Date

08/03/2021

Effective Date

05/05/2023

Expiration Date

07/31/2026

City

LAKE VILLAGE

State

Zip

60046

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/05/2023