THEODORE E LANGE MD - Medical Doctor License in Idaho | # 036098457

THEODORE E LANGE MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036098457

License Status

INACTIVE

Business

N

First Name

THEODORE

Middle

E

Last Name

LANGE

Suffix

MD

Business Name

THEODORE E LANGE MD

Original Issue Date

07/27/1998

Effective Date

07/27/1998

Expiration Date

07/31/1999

State

ID

Ever Disciplined

N

LastModifiedDate

09/20/2006