RANDALL JAMES BRENNEMAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

ACTIVE

Business

Title

First Name

RANDALL

Middle

JAMES

Last Name

BRENNEMAN

Business Name

RANDALL JAMES BRENNEMAN MD

Original Issue Date

05/14/2021

Effective Date

07/20/2023

Expiration Date

07/31/2026

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/20/2023