FREDERICK TODD WARNER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

ACTIVE

Business

Title

First Name

FREDERICK

Middle

TODD

Last Name

WARNER

Business Name

FREDERICK TODD WARNER MD

Original Issue Date

07/28/2020

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

PARK CITY

State

Zip

84098

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023