DIRK O WALES MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****29

NOT RENEWED

N

DIRK O

WALES

MD

DIRK O WALES MD

09/27/1991

09/27/1991

07/31/1993

EVANSTON

IL

60201

COOK

II III IV V

N

04/05/2020