KEITH DANIEL KRIESBERG Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005853

License Status

ACTIVE

Business

First Name

KEITH

Middle

DANIEL

Last Name

KRIESBERG

Business Name

KEITH DANIEL KRIESBERG

Original Issue Date

06/28/2016

Effective Date

01/16/2024

Expiration Date

03/01/2026

City

LA GRANGE

State

Zip

60525

County

COOK

Ever Disciplined

LastModifiedDate

12/03/2025