BARBARA ANN RUSSO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036123129

License Status

NOT RENEWED

Business

Title

First Name

BARBARA

Middle

ANN

Last Name

RUSSO

Business Name

BARBARA ANN RUSSO MD

Original Issue Date

04/09/2009

Effective Date

06/28/2017

Expiration Date

09/30/2020

City

GLEN HEAD

State

Zip

11545

County

CONNECTICUT

Ever Disciplined

LastModifiedDate

01/14/2021