WILLIAM FREDERICK SOUTHWORTH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036060822

License Status

NOT RENEWED

Business

Title

First Name

WILLIAM

Middle

FREDERICK

Last Name

SOUTHWORTH

Business Name

WILLIAM FREDERICK SOUTHWORTH MD

Original Issue Date

08/29/1980

Effective Date

08/10/2011

Expiration Date

07/31/2014

City

FARMINGTON

State

Zip

63640

County

MISSOURI

Ever Disciplined

LastModifiedDate

11/17/2014