RANDOLPH MACON RICHARDSON IV DMD Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019017839

License Status

INACTIVE

Business

First Name

RANDOLPH MACON

Last Name

RICHARDSON IV

Suffix

DMD

Business Name

RANDOLPH MACON RICHARDSON IV DMD

Original Issue Date

09/10/1981

Effective Date

09/10/1981

Expiration Date

09/30/1992

City

PHILADELPHIA

State

Zip

19101

County

PENNSYLVANIA

Ever Disciplined

LastModifiedDate

10/12/2005