BENJAMIN G LAZO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

First Name

BENJAMIN G

Last Name

LAZO

Suffix

Business Name

BENJAMIN G LAZO MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

CREVE COEUR

State

Zip

61611

County

TAZEWELL

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

09/26/2006