GREG RUSSELL LICAMELI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036095263

License Status

NOT RENEWED

Business

First Name

GREG RUSSELL

Last Name

LICAMELI

Suffix

Business Name

GREG RUSSELL LICAMELI MD

Original Issue Date

04/08/1997

Effective Date

04/08/1997

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006