License holder summary

Mitchell A. Russ is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Mitchell A. Russ is 5756 WEST 71ST STREET, INDIANAPOLIS IN 46278. This licensed professional license is not current. The license was granted 07/20/1987 and expired on 06/30/2003.

Indiana

Professional Licensing Agency

Mitchell A. Russ
Controlled Substance Registration - Physician
License number
01024796B
Date granted
07/20/1987
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
5756 WEST 71ST STREET, INDIANAPOLIS IN 46278
indianalicensing.org
ID 5870259
LAST UPDATED 2024-03-26 13:09:31 UTC

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