JEFFREY K KETCHAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

First Name

JEFFREY K

Last Name

KETCHAM

Suffix

Business Name

JEFFREY K KETCHAM MD

Original Issue Date

05/08/2003

Effective Date

06/12/2020

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023