JULIE THOMAS KIDANGAN DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****41

NOT RENEWED

N

DO

JULIE

THOMAS

KIDANGAN

JULIE THOMAS KIDANGAN DO

04/15/2013

04/15/2013

07/31/2014

DES PLAINES

IL

60016

COOK

PRACTITIONER

II III IV V

N

11/17/2014