ELIZABETH B RUSSELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

Title

First Name

ELIZABETH

Middle

Last Name

RUSSELL

Business Name

ELIZABETH B RUSSELL MD

Original Issue Date

03/19/1985

Effective Date

04/30/2015

Expiration Date

07/31/2017

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017