BARRY D SPOON DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****80

NOT RENEWED

N

BARRY D

SPOON

DO

BARRY D SPOON DO

06/21/1990

06/21/1990

07/31/1993

CARBONDALE

IL

62901

JACKSON

II III IV V

N

09/26/2006