ANDREW L LANGE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****66

License Status

NOT RENEWED

Business

First Name

ANDREW

Middle

Last Name

LANGE

Business Name

ANDREW L LANGE

Original Issue Date

02/10/2005

Effective Date

02/10/2005

Expiration Date

03/01/2008

City

DES PLAINES

State

Zip

60016

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006