RANDY DEWAIN BALMFORTH DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

ACTIVE

Business

Title

First Name

RANDY

Middle

DEWAIN

Last Name

BALMFORTH

Business Name

RANDY DEWAIN BALMFORTH DO

Original Issue Date

04/18/2013

Effective Date

07/08/2023

Expiration Date

07/31/2026

City

CARTERVILLE

State

Zip

62918

County

WILLIAMSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/08/2023