RONALD WILLIAM KELLER JR Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****30

License Status

NOT RENEWED

Business

First Name

RONALD

Middle

WILLIAM

Last Name

KELLER JR

Business Name

RONALD WILLIAM KELLER JR

Original Issue Date

03/20/2015

Effective Date

03/20/2015

Expiration Date

03/01/2016

City

WINFIELD

State

Zip

60190

County

DUPAGE

Ever Disciplined

LastModifiedDate

03/20/2015