TARA LEIGH CLANCY DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****28

NOT RENEWED

N

TARA LEIGH

CLANCY

DO

TARA LEIGH CLANCY DO

08/11/1997

04/17/2008

07/31/2011

LOMBARD

IL

60148

DUPAGE

II III IV V

N

11/10/2011