KRISTIN R LANGE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****41

License Status

NOT RENEWED

Business

First Name

KRISTIN

Middle

Last Name

LANGE

Business Name

KRISTIN R LANGE

Original Issue Date

01/17/2002

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

ARLINGTON HEIGHTS

State

Zip

60005

County

COOK

Ever Disciplined

LastModifiedDate

05/17/2010