GRANT SOULE HAMILTON III MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****39

NOT RENEWED

N

GRANT

SOULE

HAMILTON

III MD

GRANT SOULE HAMILTON III MD

05/27/2004

05/27/2004

07/31/2005

CHICAGO

IL

60612

COOK

II III IV V

N

10/09/2006