BALASUNDARAM DASARI MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****38

NOT RENEWED

N

BALASUNDARAM

DASARI

MD

BALASUNDARAM DASARI MD

09/23/1988

09/23/1988

07/31/1990

PEORIA

IL

61614

PEORIA

II III IV V

N

09/26/2006