JORGE ISAAC BASSUK MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****31

NOT RENEWED

N

JORGE ISAAC

BASSUK

MD

JORGE ISAAC BASSUK MD

09/09/1981

09/09/1981

07/31/1996

CHICAGO

IL

60611

COOK

II III IV V

N

09/26/2006