RUSSELL MARTIN PETRAK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036063551

License Status

ACTIVE

Business

First Name

RUSSELL MARTIN

Last Name

PETRAK

Suffix

Business Name

RUSSELL MARTIN PETRAK MD

Original Issue Date

11/13/1981

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Ever Disciplined

LastModifiedDate

07/27/2023