License holder summary

LISA DERENNE RUSSELL is a Board Of Medicine licensed to practice in Idaho. The address on file for LISA DERENNE RUSSELL is 2703 E 16TH AVE SPOKANE WA 99223. This licensed professional license is not current. The license was granted 03/18/2009 and expired on 07/17/2009.

Idaho

Division of Occupational and Professional Licenses

LISA DERENNE RUSSELL
Board Of Medicine
License number
PAT-697
Date granted
03/18/2009
Date expires
07/17/2009
Class
Board Of Medicine
Status
Expired
Address
2703 E 16TH AVE SPOKANE WA 99223
idaholicensing.com
ID 48363737
LAST UPDATED 2024-04-15 09:18:24 UTC

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