JAMES RANDALL WILSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

First Name

JAMES

Middle

RANDALL

Last Name

WILSON

Suffix

Business Name

JAMES RANDALL WILSON MD

Original Issue Date

06/23/1998

Effective Date

06/23/1998

Expiration Date

07/31/1999

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

09/26/2006