THEODORE E LANGE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

First Name

THEODORE

Middle

Last Name

LANGE

Suffix

Business Name

THEODORE E LANGE MD

Original Issue Date

07/28/1998

Effective Date

07/28/1998

Expiration Date

07/31/1999

City

OAK PARK

State

Zip

60302

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/26/2006