ANTHONY O ODIBO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

ACTIVE

Business

Title

First Name

ANTHONY

Middle

Last Name

ODIBO

Business Name

ANTHONY O ODIBO MD

Original Issue Date

10/14/2021

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

SHILOH

State

Zip

62269

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/13/2023