ANSHUMAN R SWAIN

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****87

NOT RENEWED

N

ANSHUMAN

R

SWAIN

ANSHUMAN R SWAIN

11/05/2007

04/17/2008

07/31/2011

MAYWOOD

IL

60153

COOK

PRACTITIONER

II III IV V

N

11/10/2011