RUSSELL ALAN JOHNSON - Physician Assistant License in Illinois | # 085005781

RUSSELL ALAN JOHNSON

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005781

License Status

NOT RENEWED

Business

N

First Name

RUSSELL

Middle

ALAN

Last Name

JOHNSON

Business Name

RUSSELL ALAN JOHNSON

Original Issue Date

02/19/2016

Effective Date

02/23/2018

Expiration Date

03/01/2020

State

IL

Ever Disciplined

N

LastModifiedDate

11/24/2020