WILLIAM FREDERICK SOUTHWORTH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

Title

First Name

WILLIAM

Middle

FREDERICK

Last Name

SOUTHWORTH

Business Name

WILLIAM FREDERICK SOUTHWORTH MD

Original Issue Date

01/01/1997

Effective Date

04/05/2011

Expiration Date

07/31/2014

City

LADUE

State

Zip

63124

County

MISSOURI

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014