| | Physician Last Name: | Russell |
| | Physician First Name: | Samuel |
| | Physician Middle Name: | J |
| | Address: | 571 St. Joseph's Boulevard
Suite 307
Elmira, NY 14901 |
| | License Number: | 009631 |
| | License Type: | PA |
| | Year of Birth: |
1980
|
| | Effective Date: | 03/22/2012 |
| | Action Description for DOH Webpage: | Censure and reprimand and $1,000 fine. The physician assistant completed the terms of his order effective April 10, 2012. |
| | Misconduct Description for DOH Webpage: | The physician assistant did not contest the charge of having been convicted in Hector Town Court, Hector, New York of driving while impaired. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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