CODY NATHANIEL RUSSELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125086836

License Status

ACTIVE

Business

Title

First Name

CODY

Middle

NATHANIEL

Last Name

RUSSELL

Business Name

CODY NATHANIEL RUSSELL MD

Original Issue Date

06/25/2025

Effective Date

06/25/2025

Expiration Date

06/24/2028

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

06/17/2025