DALE M LARSON MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****87

NOT RENEWED

N

DALE M

LARSON

MD

DALE M LARSON MD

03/18/1986

03/18/1986

07/31/1987

CHICAGO

IL

60680

COOK

II III IV V

N

09/26/2006