KEITH TIMOTHY FERGUSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036140072

License Status

NOT RENEWED

Business

Title

First Name

KEITH

Middle

TIMOTHY

Last Name

FERGUSON

Business Name

KEITH TIMOTHY FERGUSON MD

Original Issue Date

03/18/2016

Effective Date

05/18/2020

Expiration Date

07/31/2023

City

SAINT LOUIS

State

Zip

63122

Ever Disciplined

LastModifiedDate

11/30/2023