RUSSELL W BROWN II Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002271

License Status

NOT RENEWED

Business

First Name

RUSSELL

Middle

Last Name

BROWN

Suffix

Business Name

RUSSELL W BROWN II

Original Issue Date

07/27/2004

Effective Date

02/04/2020

Expiration Date

03/01/2022

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

07/27/2022