ALFONSO P LOPEZ MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****42

NOT RENEWED

N

ALFONSO P

LOPEZ

MD

ALFONSO P LOPEZ MD

09/01/1983

09/01/1983

07/31/1993

DANVILLE

IL

61832

VERMILION

II III IV V

N

09/26/2006