ELLIOTT RUSSELL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074724

License Status

EXPIRED

Business

Title

First Name

ELLIOTT

Last Name

RUSSELL

Business Name

ELLIOTT RUSSELL MD

Original Issue Date

06/25/2019

Effective Date

06/25/2019

Expiration Date

06/24/2020

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

11/19/2020