SUDHA A RUSSELL Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000241

License Status

EXPIRED

Business

First Name

SUDHA

Middle

Last Name

RUSSELL

Business Name

SUDHA A RUSSELL

Original Issue Date

04/04/1994

Effective Date

04/04/1994

Expiration Date

06/30/1994

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Addiction Psychiatry

Ever Disciplined

LastModifiedDate

09/25/2006