RANDALL CORREIA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

NOT RENEWED

Business

First Name

RANDALL

Last Name

CORREIA

Suffix

Business Name

RANDALL CORREIA MD

Original Issue Date

10/10/1989

Effective Date

07/27/2017

Expiration Date

09/30/2020

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021