KERMIT RUSSELL RUST III MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058810

License Status

EXPIRED

Business

First Name

KERMIT

Middle

RUSSELL

Last Name

RUST III

Suffix

Business Name

KERMIT RUSSELL RUST III MD

Original Issue Date

06/28/2010

Effective Date

06/28/2010

Expiration Date

06/27/2011

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/19/2011