CHRISTINE RUSSELL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000670

License Status

NOT RENEWED

Business

First Name

CHRISTINE

Last Name

RUSSELL

Business Name

CHRISTINE RUSSELL

Original Issue Date

01/25/1995

Effective Date

01/25/1995

Expiration Date

03/01/1998

City

METROPOLIS

State

Zip

62960

County

MASSAC

Ever Disciplined

LastModifiedDate

09/26/2006