| 9/2/2010 | Illinois Division of Professional Regulation | 12:06:13 PM |
| Licensee's Name | DBA / AKA | License Number | License Status | City, State | Original Date | Current Exprtn | Ever Discplned? |
|---|---|---|---|---|---|---|---|
| Edward B Lack MD | 036043409 | ACTIVE | Glenview, IL | 06/30/1970 | 07/31/2011 | N | |