CHARLES A LANE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

First Name

CHARLES A

Last Name

LANE

Suffix

Business Name

CHARLES A LANE MD

Original Issue Date

12/17/1991

Effective Date

12/17/1991

Expiration Date

07/31/1999

City

GRANITE CITY

State

Zip

62040

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020