KEITH R SMITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

First Name

KEITH R

Last Name

SMITH

Suffix

Business Name

KEITH R SMITH MD

Original Issue Date

03/18/1987

Effective Date

06/05/2017

Expiration Date

09/30/2020

City

DECATUR

State

Zip

62526

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021