RUSSELL MICHAEL FIORELLA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

ACTIVE

Business

Title

First Name

RUSSELL

Middle

MICHAEL

Last Name

FIORELLA

Business Name

RUSSELL MICHAEL FIORELLA MD

Original Issue Date

07/28/2015

Effective Date

07/06/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/06/2023