License holder summary

MICHAEL DOUGLAS RUSSELL is a Board Of Medicine licensed to practice in Idaho. The address on file for MICHAEL DOUGLAS RUSSELL is 338 Cedar Ln Longview WA 98632. This licensed professional license is not current. The license was granted 06/14/1996 and expired on 07/01/1991.

Idaho

Division of Occupational and Professional Licenses

MICHAEL DOUGLAS RUSSELL
Board Of Medicine
License number
M-7024
Date granted
06/14/1996
Date expires
07/01/1991
Class
Board Of Medicine
Status
Canceled
Address
338 Cedar Ln Longview WA 98632
idaholicensing.com
ID 48363739
LAST UPDATED 2024-03-04 18:15:35 UTC

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