License holder summary

RUSSELL JON ANDERSON is a Controlled Substance Registration-Osteopathic Physician licensed to practice in Indiana. The address on file for RUSSELL JON ANDERSON is ST MARY COMMUNITY HOSPITAL, 2515 JEFFERSON, SOUTH BEND IN 46615. This licensed professional license is not current. The license was granted 11/14/1996 and expired on 06/30/1999.

Indiana

Professional Licensing Agency

RUSSELL JON ANDERSON
Controlled Substance Registration-Osteopathic Physician
License number
02001792B
Date granted
11/14/1996
Date expires
06/30/1999
Class
Controlled Substance Registration-Osteopathic Physician
Status
Expired
Address
ST MARY COMMUNITY HOSPITAL, 2515 JEFFERSON, SOUTH BEND IN 46615
indianalicensing.org
ID 5813681
LAST UPDATED 2024-05-01 14:03:40 UTC

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