STEPHEN P RUSSO DMD - Dentist License in Illinois | # 137000623

STEPHEN P RUSSO DMD

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000623

License Status

ACTIVE

Business

N

Title

DMD

First Name

STEPHEN

Middle

P

Last Name

RUSSO

Business Name

STEPHEN P RUSSO DMD

Original Issue Date

08/03/2004

Effective Date

08/12/2024

Expiration Date

09/30/2027

State

IL

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

N

LastModifiedDate

08/12/2024