BASSAM ASSASSA MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****81

NOT RENEWED

N

BASSAM

ASSASSA

MD

BASSAM ASSASSA MD

07/23/1986

07/23/1986

07/31/1987

NORTH CHICAGO

IL

60064

LAKE

II III IV V

N

09/26/2006