ERIC JASON OKUM MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****03

NOT RENEWED

N

ERIC

JASON

OKUM

MD

ERIC JASON OKUM MD

05/19/2004

05/19/2004

07/31/2005

SKOKIE

IL

60070

COOK

II III IV V

N

10/09/2006