MARK RUSSELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036154983

License Status

NOT RENEWED

Business

Title

First Name

MARK

Last Name

RUSSELL

Business Name

MARK RUSSELL MD

Original Issue Date

12/09/2020

Effective Date

12/09/2020

Expiration Date

07/31/2023

City

VENTURA

State

Zip

93001

Ever Disciplined

LastModifiedDate

11/30/2023