License holder summary

Geoffrey Mark Randolph is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Geoffrey Mark Randolph is Summit Plastic Surgery, 11141 Parkview Plaza Drive, Suite 300, Fort Wayne IN 46845-1715. This licensed professional license is current. The license was granted 03/11/1987 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Geoffrey Mark Randolph
Controlled Substance Registration - Physician
License number
01035742B
Date granted
03/11/1987
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Summit Plastic Surgery, 11141 Parkview Plaza Drive, Suite 300, Fort Wayne IN 46845-1715
indianalicensing.org
ID 5853337
LAST UPDATED 2024-02-16 16:47:26 UTC

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