LANE MARIE LAGATTUTA DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

ACTIVE

Business

Title

First Name

LANE

Middle

MARIE

Last Name

LAGATTUTA

Business Name

LANE MARIE LAGATTUTA DO

Original Issue Date

06/18/2022

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023