LANE S LAKEN MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****29

NOT RENEWED

N

LANE

S

LAKEN

MD

LANE S LAKEN MD

07/07/1993

07/07/1993

07/31/2002

ROBINSON

IL

62454

CRAWFORD

II III IV V

N

10/09/2006