PRABHAVATHI NAMA MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****81

NOT RENEWED

N

PRABHAVATHI

NAMA

MD

PRABHAVATHI NAMA MD

01/01/1997

06/20/2011

07/31/2014

CHICAGO

IL

60661

COOK

II III IV V

N

11/17/2014