MITSUO FUWA MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****90

NOT RENEWED

N

MITSUO

FUWA

MD

MITSUO FUWA MD

01/01/1997

07/15/2008

07/31/2011

CHICAGO

IL

60614

COOK

II III IV V

N

11/10/2011