RUSSELL W FARIA DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125013772

License Status

EXPIRED

Business

First Name

RUSSELL W

Last Name

FARIA

Suffix

Business Name

RUSSELL W FARIA DO

Original Issue Date

06/17/1982

Effective Date

06/17/1982

Expiration Date

07/01/1984

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006