THOMAS E ROOT MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****36

NOT RENEWED

N

THOMAS E

ROOT

MD

THOMAS E ROOT MD

01/01/1997

05/30/2008

07/31/2011

ROSCOE

IL

61073

WINNEBAGO

II III IV V

N

11/10/2011