KEITH ALLEN PENROD Surgical Assistant/Technologist License verification

Business Entity

NOT RENEWED

License Type

Surgical Assistant/Technologist

Description

REGISTERED SURGICAL ASSISTANT

License Number

238000001

License Status

NOT RENEWED

Business

First Name

KEITH

Middle

ALLEN

Last Name

PENROD

Business Name

KEITH ALLEN PENROD

Original Issue Date

07/26/2005

Effective Date

02/08/2008

Expiration Date

04/30/2010

City

WOODRIDGE

State

Zip

60517

County

DUPAGE

Ever Disciplined

LastModifiedDate

06/08/2010