LUCILLE R RUSSO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

ACTIVE

Business

First Name

LUCILLE R

Last Name

RUSSO

Business Name

LUCILLE R RUSSO

Original Issue Date

12/03/1996

Effective Date

04/17/2023

Expiration Date

07/31/2026

City

WARRENVILLE

State

Zip

60555

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2023