PHILIP E LANE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

ACTIVE

Business

First Name

PHILIP E

Last Name

LANE

Suffix

Business Name

PHILIP E LANE MD

Original Issue Date

12/07/2020

Effective Date

07/06/2023

Expiration Date

07/31/2026

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/06/2023