JEFFREY C RUSSO DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019030410

License Status

NOT RENEWED

Business

Title

DMD

First Name

JEFFREY

Middle

Last Name

RUSSO

Business Name

JEFFREY C RUSSO DMD

Original Issue Date

08/04/2015

Effective Date

09/24/2018

Expiration Date

01/31/2022

City

LONGMEADOW

State

Zip

01106

Ever Disciplined

LastModifiedDate

05/09/2022