JOHANNA H LANGE

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****34

NOT RENEWED

N

JOHANNA

H

LANGE

JOHANNA H LANGE

04/06/2004

07/01/2008

07/31/2011

NAPERVILLE

IL

60540

DUPAGE

II III IV V

N

04/12/2017