LEHMAN E BLACK III MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****73

NOT RENEWED

N

LEHMAN E

BLACK III

MD

LEHMAN E BLACK III MD

12/22/1982

12/22/1982

07/31/1990

MAYWOOD

IL

60153

COOK

II III IV V

N

09/26/2006