KATHY RAVANBAKHSH DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****49

NOT RENEWED

N

KATHY

RAVANBAKHSH

DO

KATHY RAVANBAKHSH DO

04/21/2004

04/17/2008

07/31/2011

CHICAGO

IL

60625

COOK

II III IV V

N

11/10/2011