MARIO G LOOMIS MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****61

NOT RENEWED

N

MARIO G

LOOMIS

MD

MARIO G LOOMIS MD

03/22/1991

03/22/1991

07/31/1993

CHICAGO

IL

60611

COOK

II III IV V

N

09/26/2006