MARK LOREN KELDAHL MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049114419

License Status

NOT RENEWED

Business

First Name

MARK

Middle

LOREN

Last Name

KELDAHL

Suffix

Business Name

MARK LOREN KELDAHL MD

Original Issue Date

06/13/1996

Effective Date

06/13/1996

Expiration Date

03/31/1999

City

NORTHFIELD

State

Zip

60093

County

COOK

Ever Disciplined

LastModifiedDate

10/03/2006