RANDOLPH V ANDERSON Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****71

License Status

NOT RENEWED

Business

First Name

RANDOLPH V

Last Name

ANDERSON

Business Name

RANDOLPH V ANDERSON

Original Issue Date

01/20/1989

Effective Date

01/20/1989

Expiration Date

01/31/1991

City

FORT LEONARDWOOD

State

Zip

65473

County

MISSOURI

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2006