SALLEE TAYLOR RANDOLPH - Podiatrist License in Illinois | # 135000916

SALLEE TAYLOR RANDOLPH

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000916

License Status

EXPIRED

Business

N

First Name

SALLEE

Middle

TAYLOR

Last Name

RANDOLPH

Business Name

SALLEE TAYLOR RANDOLPH

Original Issue Date

06/08/2016

Effective Date

07/01/2016

Expiration Date

07/01/2019

State

IL

Ever Disciplined

N

LastModifiedDate

10/02/2019