MYRTLE H RUSSELL MASON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

ACTIVE

Business

First Name

MYRTLE

Middle

H RUSSELL

Last Name

MASON

Suffix

Business Name

MYRTLE H RUSSELL MASON MD

Original Issue Date

06/18/1987

Effective Date

04/14/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/14/2023