RUSSELL L ANDERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

NOT RENEWED

Business

First Name

RUSSELL L

Last Name

ANDERSON

Suffix

Business Name

RUSSELL L ANDERSON MD

Original Issue Date

10/25/1994

Effective Date

10/25/1994

Expiration Date

07/31/1996

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006