License holder summary

Russell William Pellar is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Russell William Pellar is Lake Surgical Associates, LLC, 10110 Donald Powers DR., Suite 202, Munster IN 46321. This licensed professional license is current. The license was granted 05/31/1986 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Russell William Pellar
Controlled Substance Registration - Physician
License number
01029020B
Date granted
05/31/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Lake Surgical Associates, LLC, 10110 Donald Powers DR., Suite 202, Munster IN 46321
indianalicensing.org
ID 5901431
LAST UPDATED 2024-03-29 21:56:53 UTC

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