CARLOS LARA MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****19

NOT RENEWED

N

CARLOS

LARA

MD

CARLOS LARA MD

01/01/1997

05/28/2014

07/31/2017

PITTSFIELD

IL

62363

PIKE

II III IV V

N

11/01/2017