OTHO M LACKEY JR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

CANCELLED

Business

First Name

OTHO M

Last Name

LACKEY JR

Suffix

Business Name

OTHO M LACKEY JR MD

Original Issue Date

01/09/1990

Effective Date

01/09/1990

Expiration Date

07/31/1990

City

EVANSVILLE

State

Zip

47713

County

INDIANA

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

09/26/2006