IMTIAZ ISMAIL MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****43

NOT RENEWED

N

MD

IMTIAZ

ISMAIL

IMTIAZ ISMAIL MD

08/20/2015

08/02/2017

09/30/2020

OAKBROOK TERRACE

IL

60181

LAKE

PRACTITIONER

II III IV V

N

01/14/2021