RANDOLPH S MARTIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036079474

License Status

ACTIVE

Business

First Name

RANDOLPH

Middle

Last Name

MARTIN

Suffix

Business Name

RANDOLPH S MARTIN MD

Original Issue Date

10/11/1989

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

04/12/2023