MARY K RUSSELL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067022

License Status

CANCELLED

Business

Title

First Name

MARY

Middle

Last Name

RUSSELL

Business Name

MARY K RUSSELL MD

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2019

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

02/02/2018