CHRISTOPHER M RUSSELL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078076

License Status

CANCELLED

Business

Title

First Name

CHRISTOPHER

Middle

Last Name

RUSSELL

Business Name

CHRISTOPHER M RUSSELL MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/06/2021