BANU PRASAD MYNENI DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****48

NOT RENEWED

N

DO

BANU

PRASAD

MYNENI

BANU PRASAD MYNENI DO

12/29/2017

12/29/2017

09/30/2020

ELMWOOD PARK

IL

60707

COOK

PRACTITIONER

II III IV V

N

01/14/2021