MICHAEL G RUSSELL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001461

License Status

EXPIRED

Business

Title

First Name

MICHAEL

Middle

Last Name

RUSSELL

Business Name

MICHAEL G RUSSELL MD

Original Issue Date

04/01/2023

Effective Date

04/01/2023

Expiration Date

04/30/2023

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

03/06/2024