THEODORE E LANGE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034769

License Status

EXPIRED

Business

First Name

THEODORE

Middle

Last Name

LANGE

Suffix

Business Name

THEODORE E LANGE MD

Original Issue Date

05/28/1996

Effective Date

05/28/1996

Expiration Date

06/30/1998

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

12/07/2016