RYAN MICHAEL LANE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007301

License Status

NOT RENEWED

Business

First Name

RYAN

Middle

MICHAEL

Last Name

LANE

Business Name

RYAN MICHAEL LANE

Original Issue Date

09/23/2019

Effective Date

09/23/2019

Expiration Date

03/01/2020

City

VERNON HILLS

State

Zip

60061

County

LAKE

Ever Disciplined

LastModifiedDate

11/24/2020