GORANTLA SUBBA RAO MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****87

NOT RENEWED

N

GORANTLA SUBBA

RAO

MD

GORANTLA SUBBA RAO MD

01/01/1997

09/01/1982

PARKRIDGE

IL

60068

COOK

II III IV V

N

09/26/2006