AMANDA LAUREN HORTON

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****95

NOT RENEWED

N

AMANDA

LAUREN

HORTON

AMANDA LAUREN HORTON

03/12/2009

06/08/2011

07/31/2014

EVANSTON

IL

60091

COOK

PRACTITIONER

II III IV V

N

04/05/2020