TIMOTHY J RUSSELL DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

ACTIVE

Business

First Name

TIMOTHY J

Last Name

RUSSELL

Suffix

Business Name

TIMOTHY J RUSSELL DO

Original Issue Date

02/25/1986

Effective Date

06/09/2023

Expiration Date

07/31/2026

City

TINLEY PARK

State

Zip

60487

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/09/2023