JOHN RANDALL FREDRICK MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036092269

License Status

INACTIVE

Business

First Name

JOHN RANDALL

Last Name

FREDRICK

Suffix

Business Name

JOHN RANDALL FREDRICK MD

Original Issue Date

12/28/1995

Effective Date

12/28/1995

Expiration Date

07/31/1996

City

ST LOUIS

State

Zip

63122

County

MISSOURI

Ever Disciplined

LastModifiedDate

09/20/2006