The holder whose full name is LEWIS, MARK GLENN,come from CHICAGO IL,hold the Physician license(NO.01038127A) which status is Expired Non-Renewable.
| Name | LEWIS, MARK GLENN |
|---|---|
| License Number | 01038127A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | CHICAGO |
| State | IL |