RUSSELL W CARTER DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****76

NOT RENEWED

N

RUSSELL

W

CARTER

DO

RUSSELL W CARTER DO

09/01/2000

07/10/2008

07/31/2011

ROSICLARE

IL

62982

HARDIN

II III IV V

N

11/10/2011