EDWARD LYON RANDERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036155839

License Status

NOT RENEWED

Business

Title

First Name

EDWARD

Middle

LYON

Last Name

RANDERSON

Business Name

EDWARD LYON RANDERSON MD

Original Issue Date

03/01/2021

Effective Date

03/01/2021

Expiration Date

07/31/2023

City

BEAVER DAM

State

Zip

53916

Ever Disciplined

LastModifiedDate

11/30/2023