LIRIO BL UMENGAN MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****73

NOT RENEWED

N

LIRIO BL

UMENGAN

MD

LIRIO BL UMENGAN MD

01/01/1997

01/01/1997

CHICAGO

IL

60640

COOK

II III IV V

N

09/26/2006