NICHOLAS ANTHONY RUSSO DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036167639

License Status

ACTIVE

Business

Title

First Name

NICHOLAS

Middle

ANTHONY

Last Name

RUSSO

Business Name

NICHOLAS ANTHONY RUSSO DO

Original Issue Date

11/08/2023

Effective Date

11/08/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

11/08/2023