IMTIAZ AHMAD MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****60

NOT RENEWED

N

IMTIAZ

AHMAD

MD

IMTIAZ AHMAD MD

09/27/2002

09/27/2002

07/31/2005

WAUKEGAN

IL

60085

LAKE

II III IV V

N

10/09/2006