NEIL W FREDERICKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036077771

License Status

NOT RENEWED

Business

First Name

NEIL W

Last Name

FREDERICKSON

Suffix

Business Name

NEIL W FREDERICKSON MD

Original Issue Date

08/30/1988

Effective Date

07/09/2020

Expiration Date

07/31/2023

City

RICHMOND HEIGHTS

State

Zip

63117

County

MISSOURI

Ever Disciplined

LastModifiedDate

11/30/2023