RANDOLPH S MARTIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

ACTIVE

Business

First Name

RANDOLPH

Middle

Last Name

MARTIN

Suffix

Business Name

RANDOLPH S MARTIN MD

Original Issue Date

07/23/1990

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2023