RUSSELL MARK REISNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036123778

License Status

NOT RENEWED

Business

Title

First Name

RUSSELL

Middle

MARK

Last Name

REISNER

Business Name

RUSSELL MARK REISNER MD

Original Issue Date

06/18/2009

Effective Date

06/30/2011

Expiration Date

07/31/2014

City

PHILADELPHIA

State

Zip

19124

County

PENNSYLVANIA

Ever Disciplined

LastModifiedDate

11/17/2014