RUSSELL OWEN TATE - Podiatrist License in Kansas | # 016002905

RUSSELL OWEN TATE

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016002905

License Status

NOT RENEWED

Business

N

First Name

RUSSELL OWEN

Last Name

TATE

Business Name

RUSSELL OWEN TATE

Original Issue Date

06/24/1976

Effective Date

06/24/1976

State

KS

Ever Disciplined

N

LastModifiedDate

09/25/2006