DOUGLAS JAMES RUSSO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036167243

License Status

ACTIVE

Business

Title

First Name

DOUGLAS

Middle

JAMES

Last Name

RUSSO

Business Name

DOUGLAS JAMES RUSSO MD

Original Issue Date

10/02/2023

Effective Date

10/02/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60615

Ever Disciplined

LastModifiedDate

08/21/2023