WASSIM BALLANY

Business Entity
ACTIVE

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****74

ACTIVE

N

WASSIM

BALLANY

WASSIM BALLANY

03/03/2011

06/07/2023

07/31/2026

EVERGREEN PARK

IL

60805

COOK

PRACTITIONER

II III IV V

N

06/07/2023