EILEEN GRACE TENGCO DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****59

NOT RENEWED

N

DO

EILEEN

GRACE

TENGCO

EILEEN GRACE TENGCO DO

08/29/2011

07/22/2014

07/31/2017

PARK RIDGE

IL

60068

COOK

II III IV V

N

11/01/2017