KEITH E GILMER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

NOT RENEWED

Business

First Name

KEITH E

Last Name

GILMER

Business Name

KEITH E GILMER

Original Issue Date

10/18/1995

Effective Date

10/18/1995

Expiration Date

07/31/1999

City

ROCKTON

State

Zip

61072

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020