JACLYN MARIE RUSSO PHD Clinical Psychologist License verification

Business Entity

ACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071010588

License Status

ACTIVE

Business

Title

PHD

First Name

JACLYN

Middle

MARIE

Last Name

RUSSO

Business Name

JACLYN MARIE RUSSO PHD

Original Issue Date

08/28/2021

Effective Date

07/11/2024

Expiration Date

09/30/2026

City

CHARLOTTE

State

Zip

28203

Ever Disciplined

LastModifiedDate

07/11/2024