PETER D RUSSOTTO DPM Podiatrist License verification

Business Entity

INACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016003837

License Status

INACTIVE

Business

Title

DPM

First Name

PETER D

Last Name

RUSSOTTO

Business Name

PETER D RUSSOTTO DPM

Original Issue Date

06/17/1985

Effective Date

11/30/2022

Expiration Date

01/31/2025

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Ever Disciplined

LastModifiedDate

11/04/2024