RUSSELL W FARIA DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036065676

License Status

NOT RENEWED

Business

First Name

RUSSELL W

Last Name

FARIA

Suffix

Business Name

RUSSELL W FARIA DO

Original Issue Date

11/30/1982

Effective Date

11/30/1982

Expiration Date

07/31/1999

City

HARRISBURG

State

Zip

17102

County

PENNSYLVANIA

Ever Disciplined

LastModifiedDate

09/20/2006