WESLEY ALAN RUSSELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036130605

License Status

NOT RENEWED

Business

Title

First Name

WESLEY

Middle

ALAN

Last Name

RUSSELL

Business Name

WESLEY ALAN RUSSELL MD

Original Issue Date

06/20/2012

Effective Date

06/20/2012

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014