JILL A RUSSELL Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036090868

License Status

NOT RENEWED

Business

First Name

JILL A

Last Name

RUSSELL

Business Name

JILL A RUSSELL

Original Issue Date

06/13/1995

Effective Date

06/13/1995

Expiration Date

07/31/2005

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

10/09/2006