KEITH RICHARD RIDEL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

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

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017