THOMAS G RUSSELL JR Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036090855

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

Last Name

RUSSELL

Suffix

Business Name

THOMAS G RUSSELL JR

Original Issue Date

06/10/1995

Effective Date

06/10/1995

Expiration Date

07/31/2002

City

MAYFIELD

State

Zip

42066

Ever Disciplined

LastModifiedDate

05/23/2019