COLBY SHAD THAXTON MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****35

NOT RENEWED

N

COLBY

SHAD

THAXTON

MD

COLBY SHAD THAXTON MD

07/11/2008

07/11/2008

07/31/2011

CHICAGO

IL

60611

COOK

PRACTITIONER

II III IV V

N

11/10/2011