Russell Leslie Blackburn
ExpiredCalifornia license A31946
License
- Licensed by
- Medical Board of California
- License number
- A31946
- Status
- Expired (Delinquent)
- First issued
- March 1, 1978
- Expired
- June 30, 2023
- License holder
- Russell Leslie Blackburn
- Entity type
- Individual
Classifications
- Physician and Surgeon A Physicians & Surgeons
More from the license record
- License type code
- 8002
Contact
95 Evergreen Ln
Berkeley, CA 94705-1438
Berkeley, CA 94705-1438
Alameda County