RICHARD DOUGLAS SOUTHGATE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036162961

License Status

ACTIVE

Business

Title

First Name

RICHARD

Middle

DOUGLAS

Last Name

SOUTHGATE

Business Name

RICHARD DOUGLAS SOUTHGATE MD

Original Issue Date

11/17/2022

Effective Date

07/18/2023

Expiration Date

07/31/2026

City

LAKE FOREST

State

Zip

60045

Ever Disciplined

LastModifiedDate

07/18/2023