JOHN J RUSSELL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022681

License Status

EXPIRED

Business

First Name

JOHN J

Last Name

RUSSELL

Suffix

Business Name

JOHN J RUSSELL MD

Original Issue Date

06/06/1988

Effective Date

06/06/1988

Expiration Date

07/01/1991

City

PEORIA

State

Zip

61637

County

PEORIA

Ever Disciplined

LastModifiedDate

09/22/2006