GUY ROBERT RANDOLPH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

First Name

GUY

Middle

ROBERT

Last Name

RANDOLPH

Suffix

Business Name

GUY ROBERT RANDOLPH MD

Original Issue Date

05/19/1999

Effective Date

06/03/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/03/2023