License holder summary

Phyllis H A Russell is a Medical - Physician Assistant licensed to practice in Minnesota. The address on file for Phyllis H A Russell is 4510 Blaisdell Ave S, Minneapolis, MN 55419. This licensed professional license is not current. The license was granted 03/12/1994 and expired on 06/30/2014.

Minnesota

Department of Labor and Industry

Phyllis H A Russell
Medical - Physician Assistant
License number
9105
Date granted
03/12/1994
Date expires
06/30/2014
Class
Medical - Physician Assistant
Status
Inactive
Address
4510 Blaisdell Ave S, Minneapolis, MN 55419
mnlicensing.org
ID 22354223
LAST UPDATED 2024-04-16 18:13:44 UTC

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