KIMBERLY LYNN RUSSO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036113760

License Status

NOT RENEWED

Business

First Name

KIMBERLY

Middle

LYNN

Last Name

RUSSO

Suffix

Business Name

KIMBERLY LYNN RUSSO MD

Original Issue Date

05/23/2005

Effective Date

05/27/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2011