RAZ D PENMATCHA MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****41

NOT RENEWED

N

RAZ

D

PENMATCHA

MD

RAZ D PENMATCHA MD

08/27/2001

06/15/2011

07/31/2014

ALEDO

IL

61231

MERCER

II III IV V

N

04/12/2017