License holder summary

DAVID WANLESS SOUTHWICK is a Board Of Medicine licensed to practice in Idaho. The address on file for DAVID WANLESS SOUTHWICK is 463 SOUTH SILVER BOW AVE EAGLE ID 83616. This licensed professional license is current. The license was granted 06/24/2005 and expired on 06/30/2018.

Idaho

Division of Occupational and Professional Licenses

DAVID WANLESS SOUTHWICK
Board Of Medicine
License number
LRT-1108
Date granted
06/24/2005
Date expires
06/30/2018
Class
Board Of Medicine
Status
Renewed
Address
463 SOUTH SILVER BOW AVE EAGLE ID 83616
idaholicensing.com
ID 48353779
LAST UPDATED 2024-01-30 14:41:05 UTC

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