BACK TO LIFE CHIROPRACTIC, SC
Anesthesiologist Assistant at Patriot Blvd, Glenview, IL

License number
Illinois 038010264
Category
Chiropractic
Type
Sports Physician
Owner
Name: THOMAS GODBOUT III
Title: PRESIDENT
Phone: (847) 917-3097
Address
Address 2
1352 Patriot Blvd, Glenview, IL 60026
454 N Ida Ln, Elmhurst, IL 60126
National Provider ID: 1194983650
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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BACK TO LIFE CHIROPRACTIC, S.C

Glenview, IL 60026

Registration:
May 1, 2008
State ID:
66110249
Business type:
DOMESTIC BCA
Expiration:
PERPETUAL
Agent:
Thomas Gerard Godbout,1352 Patriot Blvd, Glenview, IL 60026 (Physical)

Anesthesiologist Assistant licenses in Illinois






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