KEITH DANIEL KRIESBERG Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****56

License Status

ACTIVE

Business

First Name

KEITH

Middle

DANIEL

Last Name

KRIESBERG

Business Name

KEITH DANIEL KRIESBERG

Original Issue Date

07/19/2016

Effective Date

01/16/2024

Expiration Date

03/01/2026

City

ELMHURST

State

Zip

60126

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025