ROY D RUSSELL MD (Credential# 547383) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 2, 2003. The license expiration date date is July 31, 2004. The license status is INACTIVE.
ROY D RUSSELL MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.028787. The credential type is physician/surgeon. The effective date is July 2, 2003. The expiration date is July 31, 2004. The business address is 18802 Agincourt, San Antonio, TX 78258. The current status is inactive.
| Licensee Name | ROY D RUSSELL MD |
| Credential ID | 547383 |
| Credential Number | 1.028787 |
| Credential Type | Physician/Surgeon |
| Business Address |
18802 Agincourt San Antonio TX 78258 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1992-01-31 |
| Effective Date | 2003-07-02 |
| Expiration Date | 2004-07-31 |
| Refresh Date | 2009-07-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 158175 | CSP.0019867 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2003-03-01 - 2004-02-28 | INACTIVE |
| Street Address | 18802 AGINCOURT |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78258 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kelly E Tiller | 915 Treaty Oak, San Antonio, TX 78258 | Certified General Real Estate Appraiser | 2019-05-01 ~ 2020-04-30 |
| Jorge Londono | 38 Michelangelo, San Antonio, TX 78258 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Michelle Ping Liu | 20118 Standish Road, San Antonio, TX 78258 | Registered Nurse | 2019-09-01 ~ 2020-08-31 |
| Leenu Mary Pallickal | 422 Nueces Spring, San Antonio, TX 78258 | Pharmacist | 2016-02-01 ~ 2018-01-31 |
| Mary Elizabeth Engelhardt-pena | 1200 San Pedro #600, San Antonio, TX 78258 | Registered Nurse - Temporary | 2018-03-19 ~ 2018-07-16 |
| Barbara S Sternitzke | 806 Mandolin Wind, San Antonio, TX 78258 | Registered Nurse | 2016-09-01 ~ 2017-08-31 |
| Leslie A Alino | 26229 Midnight Watch, San Antonio, TX 78258 | Registered Nurse | 2012-08-01 ~ 2013-07-31 |
| Carmen D Cirstea | 20211 Huebner Road, San Antonio, TX 78258 | Physician/surgeon | 2012-07-01 ~ 2013-06-30 |
| Christopher P Coppola Md | 19423 Camino Ridge, San Antonio, TX 78258 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Suzanne S Grossman | 62 Champion Cliff, San Antonio, TX 78258 | Speech and Language Pathologist | 2010-09-01 ~ 2011-08-31 |
| Find all Licenses in zip 78258 | |||
| City | SAN ANTONIO |
| Zip Code | 78258 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + SAN ANTONIO |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Russell F Turk Md | Stamford Health Russell Turk, Md, Riverside, CT 06878 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Douglas R. Mailly | 119 Russell St, Cornwall, NY 12518-1711 | Physician/surgeon | ~ |
| Russell W Robertson | Po Box 234, Dublin, NH 03444-0234 | Physician/surgeon | 2012-12-01 ~ 2013-11-30 |
| Lea A Bonifacio | 416 Bluebird Drive, Russell, KY 41169 | Physician/surgeon | 2005-12-06 ~ 2007-01-31 |
| Russell L Tuverson | 8 Saw Mill Rd, Burlington, CT 06013 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Russell Aaron Van Maele | 300 Portage St, Kalamazoo, MI 49007-4929 | Physician/surgeon | ~ |
| Raymond R Russell IIi | 333 Cedar St # 3, New Haven, CT 06510-3206 | Physician/surgeon | 2017-06-01 ~ 2018-05-31 |
| Mark Quigley Md | 437 Russell Ave, Suffield, CT 06078 | Physician/surgeon | 1997-02-13 ~ 1998-04-30 |
| Russell E Windsor | 535 E 70th St, New York, NY 10021-4823 | Physician/surgeon | 2001-12-13 ~ 2010-03-31 |
Please comment or provide details below to improve the information on ROY D RUSSELL MD.
| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).