JEROME CHARLES LANE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

ACTIVE

Business

First Name

JEROME

Middle

CHARLES

Last Name

LANE

Suffix

Business Name

JEROME CHARLES LANE MD

Original Issue Date

08/09/1999

Effective Date

07/25/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/25/2023