ASEFA J MEKONNEN MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****72

NOT RENEWED

N

ASEFA

J

MEKONNEN

MD

ASEFA J MEKONNEN MD

10/01/1997

10/01/1997

07/31/2002

OAK LAWN

IL

60453

COOK

II III IV V

N

10/09/2006