NAGENDRAM PAIDISETTY

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****08

NOT RENEWED

N

NAGENDRAM

PAIDISETTY

NAGENDRAM PAIDISETTY

11/14/2005

06/15/2017

09/30/2020

PARK RIDGE

IL

60068

COOK

II III IV V

N

01/14/2021