KEITH JEROME ODEGARD MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036099391

License Status

INACTIVE

Business

First Name

KEITH

Middle

JEROME

Last Name

ODEGARD

Suffix

Business Name

KEITH JEROME ODEGARD MD

Original Issue Date

12/15/1998

Effective Date

12/15/1998

Expiration Date

07/31/2005

City

SAINT LOUIS

State

Zip

63127

County

MISSOURI

Ever Disciplined

LastModifiedDate

10/09/2006