MARY K LOCKARD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

ACTIVE

Business

First Name

MARY

Middle

Last Name

LOCKARD

Business Name

MARY K LOCKARD

Original Issue Date

06/17/2004

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023