LARA MASULLO ELLISON DO

Business Entity
ACTIVE

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****83

ACTIVE

N

LARA

MASULLO

ELLISON

DO

LARA MASULLO ELLISON DO

09/22/2005

07/05/2023

07/31/2026

NAPERVILLE

IL

60564

WILL

II III IV V

N

07/05/2023