KEITH T OLDHAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

Title

First Name

KEITH

Middle

Last Name

OLDHAM

Business Name

KEITH T OLDHAM MD

Original Issue Date

08/09/2000

Effective Date

05/02/2011

Expiration Date

07/31/2014

City

MILWAUKEE

State

Zip

53226

County

WISCONSIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014