HOLLY E RUSSELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

ACTIVE

Business

First Name

HOLLY

Middle

Last Name

RUSSELL

Suffix

Business Name

HOLLY E RUSSELL MD

Original Issue Date

04/17/2008

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

TINLEY PARK

State

Zip

60487

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023