RANDALL LOUIS BUSCH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

NOT RENEWED

Business

Title

First Name

RANDALL LOUIS

Last Name

BUSCH

Business Name

RANDALL LOUIS BUSCH MD

Original Issue Date

09/20/1995

Effective Date

07/08/2014

Expiration Date

07/31/2017

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020