RANDOLPH Y CHANG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

NOT RENEWED

Business

First Name

RANDOLPH Y

Last Name

CHANG

Suffix

Business Name

RANDOLPH Y CHANG MD

Original Issue Date

07/19/2011

Effective Date

06/06/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60640

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020