RANDALL S PASS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

ACTIVE

Business

First Name

RANDALL

Middle

Last Name

PASS

Suffix

Business Name

RANDALL S PASS MD

Original Issue Date

11/08/2006

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

MAKANDA

State

Zip

62958

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023