FAWN M RUSSELL Speech-Language Pathologist License verification

Business Entity

NOT RENEWED

License Type

Speech-Language Pathologist

Description

LICENSED SPEECH LANGUAGE PATHOLOGY TEMPORARY

License Number

242005221

License Status

NOT RENEWED

Business

First Name

FAWN

Middle

Last Name

RUSSELL

Business Name

FAWN M RUSSELL

Original Issue Date

02/23/2019

Effective Date

02/23/2019

Expiration Date

02/23/2020

City

ROCK ISLAND

State

Zip

61204

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

11/19/2020