HUMAYUN ALI KHAN LODHI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

NOT RENEWED

Business

Title

First Name

HUMAYUN

Middle

ALI KHAN

Last Name

LODHI

Business Name

HUMAYUN ALI KHAN LODHI MD

Original Issue Date

11/03/2016

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

GRANITE CITY

State

Zip

62040

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021