PAUL WILLIAM WAVAK MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****27

NOT RENEWED

N

PAUL WILLIAM

WAVAK

MD

PAUL WILLIAM WAVAK MD

01/01/1997

04/17/2008

07/31/2011

SPRINGFIELD

IL

62707

SANGAMON

II III IV V

N

11/10/2011