RANDALL STRATFORD FORTUNA MD Medical Doctor License verification

Business Entity

INOPERATIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

INOPERATIVE

Business

First Name

RANDALL

Middle

STRATFORD

Last Name

FORTUNA

Suffix

Business Name

RANDALL STRATFORD FORTUNA MD

Original Issue Date

07/29/2003

Effective Date

07/14/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61603

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/14/2023