TIMOTHY AUSTIN LANE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

CANCELLED

Business

Title

First Name

TIMOTHY

Middle

AUSTIN

Last Name

LANE

Business Name

TIMOTHY AUSTIN LANE MD

Original Issue Date

04/07/2024

Effective Date

04/07/2024

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2024