RANDY K SULAVER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

ACTIVE

Business

Title

First Name

RANDY

Middle

Last Name

SULAVER

Business Name

RANDY K SULAVER MD

Original Issue Date

07/27/2017

Effective Date

04/10/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62711

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/10/2023