ROBERT CARSON RUSSELL DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125080454

License Status

CANCELLED

Business

Title

First Name

ROBERT

Middle

CARSON

Last Name

RUSSELL

Business Name

ROBERT CARSON RUSSELL DO

Original Issue Date

07/01/2022

Effective Date

07/01/2022

Expiration Date

06/30/2025

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

12/12/2024