JEROME R RANDALL JR Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****91

License Status

NOT RENEWED

Business

First Name

JEROME

Middle

Last Name

RANDALL JR

Business Name

JEROME R RANDALL JR

Original Issue Date

06/13/2008

Effective Date

12/04/2008

Expiration Date

01/31/2011

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/10/2011