GEORGE E POLANCO DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****22

NOT RENEWED

N

GEORGE E

POLANCO

DO

GEORGE E POLANCO DO

04/04/1997

04/04/1997

07/31/1999

MATTOON

IL

61938

COLES

II III IV V

N

09/26/2006