ERIC JAY RUSSELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

ACTIVE

Business

First Name

ERIC JAY

Last Name

RUSSELL

Suffix

Business Name

ERIC JAY RUSSELL MD

Original Issue Date

01/01/1997

Effective Date

04/16/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60610

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/16/2023