RANDY SUE ELLIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

First Name

RANDY SUE

Last Name

ELLIS

Suffix

Business Name

RANDY SUE ELLIS MD

Original Issue Date

02/17/1998

Effective Date

02/17/1998

Expiration Date

07/31/1999

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006