DAVID E LANE DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036066783

License Status

NOT RENEWED

Business

First Name

DAVID E

Last Name

LANE

Suffix

Business Name

DAVID E LANE DO

Original Issue Date

06/29/1983

Effective Date

06/29/1983

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006