Information as of 10/22/2020

Last Updated by Licensee on 10/26/2005

Russell Lane Blaylock - MD
License#: 
Issue Date: 
21534
05/06/1977
License Status: 
Expire Date:
Inactive  
12/15/2006  
 Public Action: No
  
Licensee General Information
Active License
Inactive License
Reason CodeLicense NumberSubcategoryIssue DateExpire Date
By Request21534 05/06/197712/15/2006
North Carolina Hospital Admitting Privileges
Out of State Active/Inactive Licenses
None Reported
Out of Country Active/Inactive Licenses
None Reported