PHILIP E LANE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

NOT RENEWED

Business

First Name

PHILIP E

Last Name

LANE

Suffix

Business Name

PHILIP E LANE MD

Original Issue Date

03/16/2019

Effective Date

03/16/2019

Expiration Date

09/30/2020

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021