AMANDA COCHRAN LANGE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****22

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

COCHRAN

Last Name

LANGE

Business Name

AMANDA COCHRAN LANGE

Original Issue Date

10/22/2012

Effective Date

01/14/2020

Expiration Date

03/01/2022

City

EAU CLAIRE

State

Zip

54701

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022