GREGORY WAYNE RUSSELL DVM Veterinarian License verification

Business Entity

NOT RENEWED

License Type

Veterinarian

Description

LICENSED VETERINARIAN CONTROLLED SUBSTANCE

License Number

39*****72

License Status

NOT RENEWED

Business

Title

DVM

First Name

GREGORY

Middle

WAYNE

Last Name

RUSSELL

Business Name

GREGORY WAYNE RUSSELL DVM

Original Issue Date

06/26/1985

Effective Date

01/06/2009

Expiration Date

01/31/2011

City

SPARTA

State

Zip

62286

County

RANDOLPH

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/10/2011