PRATAP AGUSALA MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****46

NOT RENEWED

N

PRATAP

AGUSALA

MD

PRATAP AGUSALA MD

07/14/2005

07/03/2008

07/31/2011

CHICAGO

IL

60612

COOK

II III IV V

N

11/10/2011