RUSSELL D DONNELLY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

First Name

RUSSELL D

Last Name

DONNELLY

Suffix

Business Name

RUSSELL D DONNELLY MD

Original Issue Date

07/07/1982

Effective Date

07/07/1982

Expiration Date

07/31/1984

City

CHICAGO

State

Zip

60615

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006