LUCILLE R RUSSO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125028019

License Status

EXPIRED

Business

First Name

LUCILLE R

Last Name

RUSSO

Business Name

LUCILLE R RUSSO

Original Issue Date

05/13/1992

Effective Date

05/13/1992

Expiration Date

06/21/1995

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006