THOMAS H LANGE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

Last Name

LANGE

Suffix

Business Name

THOMAS H LANGE MD

Original Issue Date

06/01/2000

Effective Date

06/01/2000

Expiration Date

07/31/2002

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006