NATASHA NICOLE LUCKEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

Title

First Name

NATASHA

Middle

NICOLE

Last Name

LUCKEY

Business Name

NATASHA NICOLE LUCKEY MD

Original Issue Date

04/03/2014

Effective Date

06/28/2017

Expiration Date

09/30/2020

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021