JODY HANNAH LACK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122811

License Status

ACTIVE

Business

First Name

JODY

Middle

HANNAH

Last Name

LACK

Suffix

Business Name

JODY HANNAH LACK MD

Original Issue Date

03/10/2009

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Ever Disciplined

LastModifiedDate

04/07/2023