THOMAS H LANGE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102581

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

Last Name

LANGE

Suffix

Business Name

THOMAS H LANGE MD

Original Issue Date

06/01/2000

Effective Date

06/01/2000

Expiration Date

07/31/2002

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/09/2006