JEROME R RANDALL JR Podiatrist License verification

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000499

License Status

EXPIRED

Business

First Name

JEROME

Middle

Last Name

RANDALL JR

Business Name

JEROME R RANDALL JR

Original Issue Date

06/03/2002

Effective Date

06/03/2002

Expiration Date

06/30/2003

City

FRANKFORT

State

Zip

60423

County

WILL

Ever Disciplined

LastModifiedDate

09/25/2006