THOMAS J LASALLE DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****20

NOT RENEWED

N

THOMAS J

LASALLE

DO

THOMAS J LASALLE DO

03/18/1992

03/18/1992

07/31/1993

CHICAGO

IL

60612

COOK

II III IV V

N

09/26/2006