ALAN D WAMBOLDT MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****93

NOT RENEWED

N

ALAN D

WAMBOLDT

MD

ALAN D WAMBOLDT MD

08/22/1985

08/22/1985

07/31/1987

CHICAGO

IL

60607

COOK

II III IV V

N

09/26/2006