CAROLE SUE RANDOLPH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****85

License Status

NOT RENEWED

Business

First Name

CAROLE SUE

Last Name

RANDOLPH

Business Name

CAROLE SUE RANDOLPH

Original Issue Date

03/25/1985

Effective Date

03/25/1985

Expiration Date

09/30/1988

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005