KEITH BACON RITCHIE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000072

License Status

NOT RENEWED

Business

First Name

KEITH BACON

Last Name

RITCHIE

Business Name

KEITH BACON RITCHIE

Original Issue Date

11/05/1976

Effective Date

11/05/1976

Expiration Date

11/05/1978

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006