LYDIA SU MD

Business Entity
ACTIVE

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****72

ACTIVE

N

MD

LYDIA

SU

LYDIA SU MD

04/12/2024

04/12/2024

07/31/2026

OAK LAWN

IL

60453

COOK

PRACTITIONER

II III IV V

N

04/12/2024