WAYNE HENRY WIRTZ MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****38

NOT RENEWED

N

WAYNE HENRY

WIRTZ

MD

WAYNE HENRY WIRTZ MD

01/01/1997

07/31/1996

SKOKIE

IL

60076

COOK

II III IV V

N

04/05/2020