ROBERT T RUSSELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036082417

License Status

ACTIVE

Business

First Name

ROBERT T

Last Name

RUSSELL

Suffix

Business Name

ROBERT T RUSSELL MD

Original Issue Date

05/09/1991

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

04/06/2023