JANAN R LANE DO

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****97

NOT RENEWED

N

JANAN R

LANE

DO

JANAN R LANE DO

03/28/1988

03/28/1988

07/31/2002

BELLEVILLE

IL

62226

SAINT CLAIR

II III IV V

N

10/09/2006