RANDALL JAY RISINGER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

First Name

RANDALL

Middle

JAY

Last Name

RISINGER

Suffix

Business Name

RANDALL JAY RISINGER MD

Original Issue Date

03/25/2004

Effective Date

03/25/2004

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006