Ohio
Board of Licensing
Harris, Russell-SEORMC
Medical Board - 41.Pa Supervision Agreement
License number
41.14931-SA
Date granted
07/31/2012
Date expires
01/31/2015
Class
Medical Board - 41.Pa Supervision Agreement
Status
Active (In Renewal)
Address
Emily Diaz, 1341 Clark St, Cambridge, OH 43725
ohiolicensing.org
ID 29519609
LAST UPDATED 2024-04-22 01:40:27 UTC
LAST UPDATED 2024-04-22 01:40:27 UTC