RUSSELL FREDERIC LA BEAU JR MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036090286

License Status

INACTIVE

Business

First Name

RUSSELL FREDERIC

Last Name

LA BEAU JR

Suffix

Business Name

RUSSELL FREDERIC LA BEAU JR MD

Original Issue Date

03/06/1995

Effective Date

03/06/1995

Expiration Date

07/31/1999

City

JACKSON

State

Zip

49201

County

MICHIGAN

Ever Disciplined

LastModifiedDate

09/20/2006