RUSSELL OWEN TATE Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016002905

License Status

NOT RENEWED

Business

First Name

RUSSELL OWEN

Last Name

TATE

Business Name

RUSSELL OWEN TATE

Original Issue Date

06/24/1976

Effective Date

06/24/1976

City

SHAWNEE MISSION

State

Zip

66202

County

KANSAS

Ever Disciplined

LastModifiedDate

09/25/2006