RANDY L WESTERN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

NOT RENEWED

Business

First Name

RANDY L

Last Name

WESTERN

Suffix

Business Name

RANDY L WESTERN MD

Original Issue Date

07/22/1994

Effective Date

07/22/1994

Expiration Date

07/31/1996

City

SPRINGFIELD

State

Zip

62730

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020