TOMMIE RUSSELL BERRY JR Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067439

License Status

EXPIRED

Business

First Name

TOMMIE

Middle

RUSSELL

Last Name

BERRY

Suffix

Business Name

TOMMIE RUSSELL BERRY JR

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2018

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

Physical Medicine and Rehabilitation

Ever Disciplined

LastModifiedDate

10/25/2018