KEITH D BOWERSOX MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

First Name

KEITH

Middle

Last Name

BOWERSOX

Suffix

Business Name

KEITH D BOWERSOX MD

Original Issue Date

01/06/1989

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023