MARTIN T RUSSO JR DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036070725

License Status

NOT RENEWED

Business

First Name

MARTIN T

Last Name

RUSSO JR

Suffix

Business Name

MARTIN T RUSSO JR DO

Original Issue Date

06/03/1985

Effective Date

06/03/1985

Expiration Date

07/31/1999

City

WHEATON

State

Zip

60187

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/20/2006