RICHARD W LUCIO II MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****23

NOT RENEWED

N

RICHARD W

LUCIO II

MD

RICHARD W LUCIO II MD

09/01/1993

09/01/1993

07/31/1996

SCOTT AFB

IL

62225

SAINT CLAIR

II III IV V

N

04/07/2011