KIMBERLY ANN RUSSELL Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****35

License Status

ACTIVE

Business

First Name

KIMBERLY

Middle

ANN

Last Name

RUSSELL

Business Name

KIMBERLY ANN RUSSELL

Original Issue Date

03/11/2024

Effective Date

02/03/2026

Expiration Date

03/01/2028

City

MAYWOOD

State

Zip

60153

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/03/2026