| | Physician Last Name: | Sisam |
| | Physician First Name: | Randall |
| | Physician Middle Name: | Lee |
| | Address: | Address Redacted |
| | License Number: | 218061 |
| | License Type: | DO |
| | Year of Birth: |
1963
|
| | Effective Date: | 11/30/2009 |
| | Action Description for DOH Webpage: | The physician has agreed to never activate his registration or reapply for a license to practice medicine in New York State. |
| | Misconduct Description for DOH Webpage: | This is a modification of the terms previously imposed by BPMC 05-219 and does not constitute a new disciplinary action. Previously the physician did not contest the charge of negligence on more than one occasion. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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