Wisconsin
Department of Safety and Professional Services
Lane, Jack T
Medicine And Surgery
License number
16895-20
Date granted
08/12/1969
Date expires
10/31/2001
Class
Medicine And Surgery
Status
Expired
wisconsinmedicine.org
ID 12764150
LAST UPDATED 2024-01-30 08:48:19 UTC
LAST UPDATED 2024-01-30 08:48:19 UTC
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