GAYLIN D LACK MD SC - Medical Corporation License in Illinois | # 042005455

GAYLIN D LACK MD SC

Business Entity

NOT RENEWED

License Type

Medical Corporation

Description

REGISTERED MEDICAL CORPORATION

License Number

042005455

License Status

NOT RENEWED

Business

Y

Business Name

GAYLIN D LACK MD SC

Original Issue Date

08/22/1983

Effective Date

08/22/1983

Expiration Date

01/01/2004

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006