RUSSELL AARON VAN MAELE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036153807

License Status

ACTIVE

Business

Title

First Name

RUSSELL

Middle

AARON

Last Name

VAN MAELE

Business Name

RUSSELL AARON VAN MAELE DO

Original Issue Date

07/22/2020

Effective Date

06/14/2023

Expiration Date

07/31/2026

City

SANTA MONICA

State

Zip

90404

Ever Disciplined

LastModifiedDate

06/14/2023