MICHELLE KELLER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****44

License Status

NOT RENEWED

Business

First Name

MICHELLE

Last Name

KELLER

Business Name

MICHELLE KELLER

Original Issue Date

12/16/2014

Effective Date

12/16/2014

Expiration Date

03/01/2016

City

WINFIELD

State

Zip

60190

County

DUPAGE

Ever Disciplined

LastModifiedDate

03/17/2016