RANDOLPH HARLEN ROBERTSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

First Name

RANDOLPH

Middle

HARLEN

Last Name

ROBERTSON

Suffix

Business Name

RANDOLPH HARLEN ROBERTSON MD

Original Issue Date

01/31/2011

Effective Date

04/11/2011

Expiration Date

07/31/2014

City

KOKOMO

State

Zip

46902

County

INDIANA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014