TIMOTHY JAMES VON FANGE MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****35

NOT RENEWED

N

MD

TIMOTHY

JAMES

VON FANGE

TIMOTHY JAMES VON FANGE MD

06/06/2008

06/06/2008

07/31/2011

GOLDEN

IL

62339

ADAMS

II III IV V

N

11/10/2011