RAMA VAITLA MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****45

NOT RENEWED

N

RAMA

VAITLA

MD

RAMA VAITLA MD

03/19/2001

04/17/2008

07/31/2011

LA GRANGE PK

IL

60526

COOK

II III IV V

N

11/10/2011