State of Illinois - License Look-up Results
11/20/2009 Illinois Division of Professional Regulation 8:01:37 PM

You requested license number: 036-043409

Licensee's Name DBA /
AKA
License
Number
License
Status
City, State Original
Date
Current
Exprtn
Ever Discplned?
Edward B Lack MD 036043409 ACTIVEGlenview, IL06/30/1970 07/31/2011 N

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