FAWN M RUSSELL Speech-Language Pathologist License verification

Business Entity

ACTIVE

License Type

Speech-Language Pathologist

Description

SPEECH LANGUAGE PATHOLOGIST

License Number

146015288

License Status

ACTIVE

Business

First Name

FAWN

Middle

Last Name

RUSSELL

Business Name

FAWN M RUSSELL

Original Issue Date

05/05/2020

Effective Date

08/16/2025

Expiration Date

10/31/2027

City

ROCK ISLAND

State

Zip

61204

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

08/16/2025