License holder summary

Stephanie Jane Russ is a Controlled Substance Registration-Osteopathic Physician licensed to practice in Indiana. The address on file for Stephanie Jane Russ is 1251 S. Huntzinger Blvd Suite 100, Pendleton IN 46064. This licensed professional license is current. The license was granted 09/04/2009 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Stephanie Jane Russ
Controlled Substance Registration-Osteopathic Physician
License number
02003568B
Date granted
09/04/2009
Date expires
10/31/2015
Class
Controlled Substance Registration-Osteopathic Physician
Status
Active
Address
1251 S. Huntzinger Blvd Suite 100, Pendleton IN 46064
indianalicensing.org
ID 5811463
LAST UPDATED 2024-02-26 08:35:25 UTC

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