GAYLE SOUTHWORTH VEST MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036052206

License Status

NOT RENEWED

Business

First Name

GAYLE SOUTHWORTH

Last Name

VEST

Suffix

Business Name

GAYLE SOUTHWORTH VEST MD

Original Issue Date

12/19/1975

Effective Date

12/19/1975

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/20/2006