JOHANNA H LANGE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036110672

License Status

NOT RENEWED

Business

First Name

JOHANNA

Middle

Last Name

LANGE

Business Name

JOHANNA H LANGE

Original Issue Date

01/09/2004

Effective Date

05/01/2014

Expiration Date

07/31/2017

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/01/2017