MARK JOSEPH RUSSO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036126542

License Status

NOT RENEWED

Business

Title

First Name

MARK

Middle

JOSEPH

Last Name

RUSSO

Business Name

MARK JOSEPH RUSSO MD

Original Issue Date

08/23/2010

Effective Date

05/11/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014