JIM Y WANG DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****81

NOT RENEWED

N

JIM

Y

WANG

DO

JIM Y WANG DO

08/21/1998

08/21/1998

07/31/1999

ROCKFORD

IL

61104

WINNEBAGO

II III IV V

N

09/26/2006