KEITH RICHARD RIDEL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036140431

License Status

NOT RENEWED

Business

Title

First Name

KEITH

Middle

RICHARD

Last Name

RIDEL

Business Name

KEITH RICHARD RIDEL MD

Original Issue Date

04/19/2016

Effective Date

04/19/2016

Expiration Date

07/31/2017

City

CARMEL

State

Zip

46033

County

INDIANA

Ever Disciplined

LastModifiedDate

11/01/2017