OMMA G VAIDYA

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****47

NOT RENEWED

N

OMMA

G

VAIDYA

OMMA G VAIDYA

04/20/2004

04/20/2004

07/31/2005

PARK RIDGE

IL

60068

COOK

II III IV V

N

04/12/2017