LARRY DALE OTTE DMD Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

INACTIVE

Business

First Name

LARRY DALE

Last Name

OTTE

Suffix

DMD

Business Name

LARRY DALE OTTE DMD

Original Issue Date

07/21/2015

Effective Date

08/10/2018

Expiration Date

12/31/2021

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/08/2021