RUSSELL S OWENS Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125023210

License Status

EXPIRED

Business

First Name

RUSSELL

Middle

Last Name

OWENS

Business Name

RUSSELL S OWENS

Original Issue Date

01/09/1989

Effective Date

01/09/1989

Expiration Date

01/01/1992

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Addiction Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006