Ohio
Board of Licensing
Dr. Jack Russell Lake Jr.
Medical Board - 34.Doctor Of Osteopathic Medicine
License number
34.009305
Date granted
05/14/2008
Date expires
07/01/2010
Class
Medical Board - 34.Doctor Of Osteopathic Medicine
Status
Inactive
Address
Edmond, OK 73003
ohiolicensing.org
ID 28956319
LAST UPDATED 2026-07-19 00:57:59 UTC
LAST UPDATED 2026-07-19 00:57:59 UTC