LUCILLE R RUSSO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036090412

License Status

ACTIVE

Business

First Name

LUCILLE R

Last Name

RUSSO

Business Name

LUCILLE R RUSSO

Original Issue Date

03/28/1995

Effective Date

04/17/2023

Expiration Date

07/31/2026

City

WHEATON

State

Zip

60187

County

DUPAGE

Ever Disciplined

LastModifiedDate

04/17/2023