Individual
MR. RANDY L LIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.C.O., B.A.D.O.
Contact information
Practice address
1318 W CANDLETREE DR, SUITE 3, PEORIA, IL 61614-8508
(309) 676-3663
(309) 676-0359
Mailing address
1318 W CANDLETREE DR, SUITE 3, PEORIA, IL 61614-8508
(309) 676-3663
(309) 676-0359
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
203.000116
IL
Other
Enumeration date
06/12/2006
Last updated
07/03/2009
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