RUSSELL W AUSTIN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027194

License Status

EXPIRED

Business

First Name

RUSSELL

Middle

Last Name

AUSTIN

Business Name

RUSSELL W AUSTIN

Original Issue Date

06/17/1991

Effective Date

06/17/1991

Expiration Date

06/20/1995

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006