DANIEL E WACHENHEIM MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****62

NOT RENEWED

N

DANIEL

E

WACHENHEIM

MD

DANIEL E WACHENHEIM MD

03/13/2000

03/13/2000

07/31/2002

CHICAGO

IL

60612

COOK

II III IV V

N

10/09/2006