CRISALE C COSAS MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****00

NOT RENEWED

N

CRISALE C

COSAS

MD

CRISALE C COSAS MD

04/08/1993

07/29/2008

07/31/2011

GRANITE CITY

IL

62040

MADISON

II III IV V

N

11/10/2011