MARK RUSSELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036159014

License Status

ACTIVE

Business

Title

First Name

MARK

Last Name

RUSSELL

Business Name

MARK RUSSELL MD

Original Issue Date

12/17/2021

Effective Date

04/29/2023

Expiration Date

07/31/2026

City

WOODRIDGE

State

Zip

60517

Ever Disciplined

LastModifiedDate

04/29/2023