KEITH MICHAEL LADENDORF Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002545

License Status

ACTIVE

Business

First Name

KEITH

Middle

MICHAEL

Last Name

LADENDORF

Business Name

KEITH MICHAEL LADENDORF

Original Issue Date

08/24/2005

Effective Date

01/15/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60631

Ever Disciplined

LastModifiedDate

01/15/2026