NICHOLAS LANGE MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036124672

License Status

INACTIVE

Business

First Name

NICHOLAS

Last Name

LANGE

Suffix

Business Name

NICHOLAS LANGE MD

Original Issue Date

11/30/2009

Effective Date

04/18/2011

Expiration Date

07/31/2014

City

WEST SACRAMENTO

State

Zip

95691

County

GEORGIA

Ever Disciplined

LastModifiedDate

04/08/2014