License holder summary

RUSSELL JAN GEOFFREY is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for RUSSELL JAN GEOFFREY is GARY COMMUNITY MENTAL HEALTH CENTER, 1100 W SIXTH AVE, GARY IN 46402. This licensed professional license is not current. The license was granted 11/09/1988 and expired on 06/30/1991.

Indiana

Professional Licensing Agency

RUSSELL JAN GEOFFREY
Controlled Substance Registration - Physician
License number
01037155B
Date granted
11/09/1988
Date expires
06/30/1991
Class
Controlled Substance Registration - Physician
Status
Expired
Address
GARY COMMUNITY MENTAL HEALTH CENTER, 1100 W SIXTH AVE, GARY IN 46402
indianalicensing.org
ID 5857478
LAST UPDATED 2024-03-19 10:20:53 UTC

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