GREGORY MARSHALL RANDOLPH DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019020416

License Status

ACTIVE

Business

First Name

GREGORY

Middle

MARSHALL

Last Name

RANDOLPH

Suffix

DDS

Business Name

GREGORY MARSHALL RANDOLPH DDS

Original Issue Date

11/13/1986

Effective Date

05/31/2024

Expiration Date

09/30/2027

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/31/2024