J RANDOLPH LEWIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036069805

License Status

NOT RENEWED

Business

First Name

J RANDOLPH

Last Name

LEWIS

Suffix

Business Name

J RANDOLPH LEWIS MD

Original Issue Date

11/07/1984

Effective Date

06/11/2008

Expiration Date

07/31/2011

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

11/14/2011