DANIEL P LANGE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035695

License Status

EXPIRED

Business

First Name

DANIEL

Middle

Last Name

LANGE

Business Name

DANIEL P LANGE

Original Issue Date

04/25/1997

Effective Date

04/25/1997

Expiration Date

06/30/2002

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

09/22/2006