ANTHONY LEONARD RUSSO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125026446

License Status

EXPIRED

Business

First Name

ANTHONY LEONARD

Last Name

RUSSO

Suffix

Business Name

ANTHONY LEONARD RUSSO MD

Original Issue Date

05/06/1991

Effective Date

05/06/1991

Expiration Date

06/30/1994

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006