Indiana
Professional Licensing Agency
DANIELLE RENEE RUSSO
Controlled Substance Registration - Physician
License number
01057584B
Date granted
05/10/2003
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Wakarusa Medical Clinic, 207 North Elkhart P O Box 446, Wakarusa IN 46573
indianalicensing.org
ID 5932098
LAST UPDATED 2024-01-26 05:56:10 UTC
LAST UPDATED 2024-01-26 05:56:10 UTC
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