RUSSELL JUAN GRAY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000145

License Status

EXPIRED

Business

First Name

RUSSELL

Middle

JUAN

Last Name

GRAY

Suffix

Business Name

RUSSELL JUAN GRAY MD

Original Issue Date

12/19/2001

Effective Date

12/19/2001

Expiration Date

06/18/2002

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

09/23/2006