L MARK RUSSAKOFF MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036052286

License Status

NOT RENEWED

Business

First Name

L MARK

Last Name

RUSSAKOFF

Suffix

Business Name

L MARK RUSSAKOFF MD

Original Issue Date

01/16/1976

Effective Date

01/16/1976

City

HIGHLAND PARK

State

Zip

60035

County

LAKE

Ever Disciplined

LastModifiedDate

09/20/2006