JAMES TIMOTHY LANE MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****96

NOT RENEWED

N

JAMES TIMOTHY

LANE

MD

JAMES TIMOTHY LANE MD

03/10/1986

03/10/1986

07/31/1990

CHICAGO

IL

60612

COOK

II III IV V

N

09/26/2006