CHARLES A LANE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

ACTIVE

Business

First Name

CHARLES A

Last Name

LANE

Suffix

Business Name

CHARLES A LANE MD

Original Issue Date

02/05/1993

Effective Date

07/11/2023

Expiration Date

07/31/2026

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2023