RANDY A PONCHER MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036043432

License Status

INACTIVE

Business

First Name

RANDY A

Last Name

PONCHER

Suffix

Business Name

RANDY A PONCHER MD

Original Issue Date

06/30/1970

Effective Date

06/03/2011

Expiration Date

07/31/2014

City

HIGHLAND PARK

State

Zip

60035

County

LAKE

Ever Disciplined

LastModifiedDate

04/08/2014