GREGORY C RANDLE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

NOT RENEWED

Business

First Name

GREGORY C

Last Name

RANDLE

Suffix

Business Name

GREGORY C RANDLE MD

Original Issue Date

01/14/2016

Effective Date

01/14/2016

Expiration Date

07/31/2017

City

MARYVILLE

State

Zip

62062

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017