ANTHONY LEONARD RUSSO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036087022

License Status

NOT RENEWED

Business

First Name

ANTHONY LEONARD

Last Name

RUSSO

Suffix

Business Name

ANTHONY LEONARD RUSSO MD

Original Issue Date

07/29/1993

Effective Date

07/29/1993

Expiration Date

07/31/1996

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

09/20/2006