STEPHEN RICHARD RUSSELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

NOT RENEWED

Business

First Name

STEPHEN RICHARD

Last Name

RUSSELL

Suffix

Business Name

STEPHEN RICHARD RUSSELL MD

Original Issue Date

01/10/1989

Effective Date

01/10/1989

Expiration Date

07/31/1999

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006