OTHO M LACKEY JR MD - Medical Doctor License in Indiana | # 036079200

OTHO M LACKEY JR MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036079200

License Status

INACTIVE

Business

N

First Name

OTHO M

Last Name

LACKEY JR

Suffix

MD

Business Name

OTHO M LACKEY JR MD

Original Issue Date

07/19/1989

Effective Date

07/19/1989

Expiration Date

07/31/1990

State

IN

Ever Disciplined

N

LastModifiedDate

09/20/2006