RANDALL CLIVE EDGELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

ACTIVE

Business

First Name

RANDALL

Middle

CLIVE

Last Name

EDGELL

Suffix

Business Name

RANDALL CLIVE EDGELL MD

Original Issue Date

05/08/2018

Effective Date

05/13/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/13/2023