AVIDA NUBIA BUSSELL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055390

License Status

CANCELLED

Business

Title

First Name

AVIDA

Middle

NUBIA

Last Name

BUSSELL

Business Name

AVIDA NUBIA BUSSELL MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2012

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

06/17/2011