RANDOLPH WILLIAM ROLLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

NOT RENEWED

Business

First Name

RANDOLPH

Middle

WILLIAM

Last Name

ROLLER

Suffix

Business Name

RANDOLPH WILLIAM ROLLER MD

Original Issue Date

01/01/1997

Effective Date

06/25/2014

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017