LEE STUART RUSAKOW MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****10

NOT RENEWED

N

LEE STUART

RUSAKOW

MD

LEE STUART RUSAKOW MD

08/27/1997

08/27/1997

07/31/2002

GURNEE

IL

60031

LAKE

II III IV V

N

10/09/2006