WESLEY ALAN RUSSELL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057107

License Status

CANCELLED

Business

Title

First Name

WESLEY

Middle

ALAN

Last Name

RUSSELL

Business Name

WESLEY ALAN RUSSELL MD

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

CHICAG

State

Zip

60612

County

COOK

Specialty/Qualifier

Radiation Oncology

Ever Disciplined

LastModifiedDate

06/23/2009