RAZ D PENMATCHA MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****40

NOT RENEWED

N

RAZ

D

PENMATCHA

MD

RAZ D PENMATCHA MD

08/27/2001

06/15/2011

07/31/2014

KEWANEE

IL

61443

HENRY

II III IV V

N

04/12/2017