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Get Idph Lead Contractor Application Form

LEAD-CONTRACTOR ID For IDPH Use CONTRACTOR APPLICATION - LEAD ABATEMENT PROGRAM ILLINOIS DEPARTMENT OF PUBLIC HEALTH DIVISION OF ENVIRONMENTAL HEALTH 525 WEST JEFFERSON STREET 3RD FLOOR SPRINGFIELD ILLINOIS 62761 500 License Fee must accompany this application BUSINESS NAME CONTACT PERSON BUSINESS ADDRESS Street CITY COUNTY STATE BUSINESS TELEPHONE ZIP FAX TYPE OF OWNERSHIP Check Sole Proprietorship Corporation Trust Partnership Association Other.

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