KEITH ALLEN WICHTERMAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036058831

License Status

ACTIVE

Business

First Name

KEITH ALLEN

Last Name

WICHTERMAN

Suffix

Business Name

KEITH ALLEN WICHTERMAN MD

Original Issue Date

07/06/1979

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62704

Ever Disciplined

LastModifiedDate

04/06/2023