JENNIFER CLAIRE LANE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

ACTIVE

Business

Title

First Name

JENNIFER

Middle

CLAIRE

Last Name

LANE

Business Name

JENNIFER CLAIRE LANE DO

Original Issue Date

07/10/2015

Effective Date

06/09/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/17/2023