ROBERT T RUSSELL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125021885

License Status

EXPIRED

Business

First Name

ROBERT T

Last Name

RUSSELL

Suffix

Business Name

ROBERT T RUSSELL MD

Original Issue Date

05/04/1988

Effective Date

05/04/1988

Expiration Date

07/01/1991

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Addiction Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006