SUSAN R RUSSELL Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036117380

License Status

ACTIVE

Business

First Name

SUSAN

Middle

Last Name

RUSSELL

Business Name

SUSAN R RUSSELL

Original Issue Date

12/27/2006

Effective Date

06/28/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

06/28/2023