MARTIN F RANDOLPH
Physician/surgeon


Address: 70 Deer Hill Ave, Danbury, CT 06810

MARTIN F RANDOLPH (Credential# 538571) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 8, 1998. The license expiration date date is July 31, 1999. The license status is INACTIVE.

Business Overview

MARTIN F RANDOLPH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.005917. The credential type is physician/surgeon. The effective date is May 8, 1998. The expiration date is July 31, 1999. The business address is 70 Deer Hill Ave, Danbury, CT 06810. The current status is inactive.

Basic Information

Licensee Name MARTIN F RANDOLPH
Credential ID 538571
Credential Number 1.005917
Credential Type Physician/Surgeon
Business Address 70 Deer Hill Ave
Danbury
CT 06810
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1948-06-24
Effective Date 1998-05-08
Expiration Date 1999-07-31
Refresh Date 2009-07-08

Other licenses

ID Credential Code Credential Type Issue Term Status
150889 CSP.0001897 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 1997-03-01 - 1998-02-28 INACTIVE

Office Location

Street Address 70 DEER HILL AVE
City DANBURY
State CT
Zip Code 06810

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City DANBURY
Zip Code 06810
License Type Physician/Surgeon
License Type + County Physician/Surgeon + DANBURY

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Dataset Information

Data Provider Connecticut Department of Consumer Protection
Jurisdiction Connecticut
Related Datasets Connecticut Business Registrations, Connecticut Child Care Facilities

This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).

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