JOHANNA H LANGE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040840

License Status

EXPIRED

Business

First Name

JOHANNA

Middle

Last Name

LANGE

Business Name

JOHANNA H LANGE

Original Issue Date

06/12/2000

Effective Date

06/12/2000

Expiration Date

06/11/2001

City

BERWYN

State

Zip

60402

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006