RANDY A PONCHER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

First Name

RANDY A

Last Name

PONCHER

Suffix

Business Name

RANDY A PONCHER MD

Original Issue Date

06/25/1990

Effective Date

06/25/1990

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011