License holder summary

MARVIN L MC INTOSH is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for MARVIN L MC INTOSH is FORT WAYNE ASSEMBLY-GM, 12200 LAFAYETTE CENTER ROAD, ROANOKE IN 46783. This licensed professional license is not current. The license was granted 11/25/1986 and expired on 06/30/2001.

Indiana

Professional Licensing Agency

MARVIN L MC INTOSH
Controlled Substance Registration - Physician
License number
01035583B
Date granted
11/25/1986
Date expires
06/30/2001
Class
Controlled Substance Registration - Physician
Status
Expired
Address
FORT WAYNE ASSEMBLY-GM, 12200 LAFAYETTE CENTER ROAD, ROANOKE IN 46783
indianalicensing.org
ID 5914971
LAST UPDATED 2024-03-10 19:48:37 UTC

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