MARK G VASELAKOS DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****85

NOT RENEWED

N

MARK

G

VASELAKOS

DO

MARK G VASELAKOS DO

10/01/2003

04/18/2011

07/31/2014

ROCKFORD

IL

61104

WINNEBAGO

II III IV V

N

04/05/2020