PRADEEP GOLLA DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****17

NOT RENEWED

N

DO

PRADEEP

GOLLA

PRADEEP GOLLA DO

02/24/2010

05/31/2011

07/31/2014

OLYMPIA FIELDS

IL

60461

COOK

PRACTITIONER

II III IV V

N

11/17/2014