LANNY S ODIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

NOT RENEWED

Business

First Name

LANNY S

Last Name

ODIN

Suffix

Business Name

LANNY S ODIN MD

Original Issue Date

09/22/1988

Effective Date

09/22/1988

Expiration Date

07/31/1999

City

FAIRVIEW HEIGHTS

State

Zip

62208

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020