ROBERT CARSON RUSSELL DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036173028

License Status

ACTIVE

Business

Title

First Name

ROBERT

Middle

CARSON

Last Name

RUSSELL

Business Name

ROBERT CARSON RUSSELL DO

Original Issue Date

12/12/2024

Effective Date

12/12/2024

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

County

PEORIA

Ever Disciplined

LastModifiedDate

12/03/2024