LANNY S ODIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

First Name

LANNY S

Last Name

ODIN

Suffix

Business Name

LANNY S ODIN MD

Original Issue Date

03/29/1999

Effective Date

05/30/2017

Expiration Date

09/30/2020

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021