SAMUEL GUY RUSSELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036151799

License Status

ACTIVE

Business

Title

First Name

SAMUEL

Middle

GUY

Last Name

RUSSELL

Business Name

SAMUEL GUY RUSSELL MD

Original Issue Date

02/11/2020

Effective Date

05/27/2023

Expiration Date

07/31/2026

City

LINCOLNSHIRE

State

Zip

60069

County

LAKE

Ever Disciplined

LastModifiedDate

05/27/2023