MICHAEL RUSSO DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

ACTIVE

Business

Title

First Name

MICHAEL

Last Name

RUSSO

Business Name

MICHAEL RUSSO DO

Original Issue Date

12/06/2021

Effective Date

05/01/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/01/2023