S ELLEN RUSSELL Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125019892

License Status

EXPIRED

Business

First Name

S ELLEN

Last Name

RUSSELL

Business Name

S ELLEN RUSSELL

Original Issue Date

06/26/1986

Effective Date

06/26/1986

Expiration Date

06/24/1989

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006