SCOTT S RUSSO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036079026

License Status

NOT RENEWED

Business

First Name

SCOTT S

Last Name

RUSSO

Suffix

Business Name

SCOTT S RUSSO MD

Original Issue Date

06/17/1989

Effective Date

06/17/1989

Expiration Date

07/31/1990

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/20/2006