Ohio
Board of Licensing
Lane, Modish - CCF-South Pointe Hospital
Medical Board - 41.Pa Supervision Agreement
License number
41.4194-SA
Date granted
01/20/2004
Date expires
01/31/2015
Class
Medical Board - 41.Pa Supervision Agreement
Status
Active (In Renewal)
Address
Attn: Carol Weber, PA-C, 20000 Harvard Rd., Room 233, Warrensville Hts, OH 44122
ohiolicensing.org
ID 28678107
LAST UPDATED 2026-05-23 00:43:53 UTC
LAST UPDATED 2026-05-23 00:43:53 UTC