CARSON FAIRFIELD WOODBURY MD

Business Entity
ACTIVE

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****20

ACTIVE

N

MD

CARSON

FAIRFIELD

WOODBURY

CARSON FAIRFIELD WOODBURY MD

07/13/2023

07/13/2023

07/31/2026

MAYWOOD

IL

60153

COOK

PRACTITIONER

II III IV V

N

07/13/2023