BASIL P STAMOS MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****75

NOT RENEWED

N

BASIL P

STAMOS

MD

BASIL P STAMOS MD

10/03/1991

10/03/1991

07/31/1993

CHICAGO

IL

60610

COOK

II III IV V

N

09/26/2006