OTHO M LACKEY JR MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036079200

License Status

INACTIVE

Business

First Name

OTHO M

Last Name

LACKEY JR

Suffix

Business Name

OTHO M LACKEY JR MD

Original Issue Date

07/19/1989

Effective Date

07/19/1989

Expiration Date

07/31/1990

City

EVANSVILLE

State

Zip

47713

County

INDIANA

Ever Disciplined

LastModifiedDate

09/20/2006