RUSSELL E SHIELDS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036097950

License Status

NOT RENEWED

Business

First Name

RUSSELL

Middle

Last Name

SHIELDS

Business Name

RUSSELL E SHIELDS

Original Issue Date

06/09/1998

Effective Date

06/09/1998

Expiration Date

07/31/1999

City

PADUCAH

State

Zip

42001

Ever Disciplined

LastModifiedDate

09/20/2006