LOGAN LACKEY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036160814

License Status

ACTIVE

Business

Title

First Name

LOGAN

Last Name

LACKEY

Business Name

LOGAN LACKEY MD

Original Issue Date

06/09/2022

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

QUINCY

State

Zip

62301

Ever Disciplined

LastModifiedDate

07/12/2023