PETER D RUSSOTTO DPM Podiatrist License verification

Business Entity

INOPERATIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****06

License Status

INOPERATIVE

Business

Title

DPM

First Name

PETER D

Last Name

RUSSOTTO

Business Name

PETER D RUSSOTTO DPM

Original Issue Date

06/18/1985

Effective Date

11/12/2024

Expiration Date

01/31/2027

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/16/2025