JEANNE RUSSO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****91

License Status

NOT RENEWED

Business

First Name

JEANNE

Last Name

RUSSO

Business Name

JEANNE RUSSO

Original Issue Date

11/24/2020

Effective Date

01/08/2022

Expiration Date

03/01/2024

City

CHICAGO

State

Zip

60637

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025