ROY MONGKOLPRADIT MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****61

NOT RENEWED

N

ROY

MONGKOLPRADIT

MD

ROY MONGKOLPRADIT MD

11/27/2002

11/27/2002

07/31/2005

CHICAGO

IL

60637

COOK

II III IV V

N

10/09/2006