DOUGLAS CHARLES DEDELOW DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****15

NOT RENEWED

N

DOUGLAS CHARLES

DEDELOW

DO

DOUGLAS CHARLES DEDELOW DO

08/10/1994

08/10/1994

07/31/1999

CHICAGO

IL

60615

COOK

II III IV V

N

09/26/2006