RANDALL CORREIA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036079279

License Status

NOT RENEWED

Business

First Name

RANDALL

Last Name

CORREIA

Suffix

Business Name

RANDALL CORREIA MD

Original Issue Date

08/05/1989

Effective Date

07/27/2017

Expiration Date

09/30/2020

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/14/2021