AMAYA LOPEZ BUSTINDUY MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****99

NOT RENEWED

N

AMAYA

LOPEZ BUSTINDUY

MD

AMAYA LOPEZ BUSTINDUY MD

08/28/2006

08/28/2006

07/31/2008

CHICAGO

IL

60612

COOK

II III IV V

N

11/06/2008