L MARK RUSSAKOFF MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

NOT RENEWED

Business

First Name

L MARK

Last Name

RUSSAKOFF

Suffix

Business Name

L MARK RUSSAKOFF MD

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

HIGHLAND PARK

State

Zip

60035

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006