The holder whose full name is Shatford, Russell Alexander,come from Louisville KY,hold the Medical Residency Permit license(NO.11007570A) which status is Superceded.
| Name | Shatford, Russell Alexander |
|---|---|
| License Number | 11007570A |
| License Type | Medical Residency Permit |
| License Status | Superceded |
| City | Louisville |
| State | KY |