KEITH R THOMAE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

NOT RENEWED

Business

First Name

KEITH R

Last Name

THOMAE

Suffix

Business Name

KEITH R THOMAE MD

Original Issue Date

06/19/2006

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

HIGHLAND

State

Zip

62249

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020