LARRY R LANE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

CANCELLED

Business

First Name

LARRY R

Last Name

LANE

Suffix

Business Name

LARRY R LANE MD

Original Issue Date

01/01/1997

Effective Date

06/02/2011

Expiration Date

07/31/2014

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/02/2011