MICHAEL EDWARD TRICE MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****07

NOT RENEWED

N

MICHAEL

EDWARD

TRICE

MD

MICHAEL EDWARD TRICE MD

11/09/1999

11/09/1999

07/31/2008

DECATUR

IL

62526

MACON

II III IV V

N

11/06/2008