KIDANU BIRHANU

Business Entity
ACTIVE

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****06

ACTIVE

N

KIDANU

BIRHANU

KIDANU BIRHANU

03/06/1987

05/09/2023

07/31/2026

EVERGREEN PARK

IL

60805

COOK

II III IV V

N

05/09/2023