Jennifer Brooke Russell
ExpiredIllinois license 085004452
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 085004452
- Status
- Expired (Not Renewed)
- First issued
- September 17, 2012
- Expired
- March 1, 2014
- License holder
- Jennifer Brooke Russell
- Entity type
- Individual
Classifications
- Licensed Physician Assistant Physicians & Surgeons
More from the license record
- Current term began
- 09/17/2012
Contact
Glenville, NY 12302
New York County