HOWARD S MITZ DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****24

NOT RENEWED

N

HOWARD S

MITZ

DO

HOWARD S MITZ DO

09/23/1988

09/23/1988

07/31/1993

ALTON

IL

62002

MADISON

II III IV V

N

10/09/2006