RUSSELL E COULTER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

ACTIVE

Business

First Name

RUSSELL E

Last Name

COULTER

Suffix

Business Name

RUSSELL E COULTER MD

Original Issue Date

05/07/1982

Effective Date

06/02/2023

Expiration Date

07/31/2026

City

SPARTA

State

Zip

62286

County

RANDOLPH

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/02/2023