RUSSELL MARTIN CARLSON DPM Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016005439

License Status

ACTIVE

Business

Title

DPM

First Name

RUSSELL

Middle

MARTIN

Last Name

CARLSON

Business Name

RUSSELL MARTIN CARLSON DPM

Original Issue Date

05/20/2010

Effective Date

11/01/2024

Expiration Date

01/31/2027

City

DAVENPORT

State

Zip

52807

County

SCOTT

Ever Disciplined

LastModifiedDate

11/01/2024