OTIS ALLEN MD SC Medical Corporation License verification

Business Entity

NOT RENEWED

License Type

Medical Corporation

Description

REGISTERED MEDICAL CORPORATION

License Number

042618399

License Status

NOT RENEWED

Business

Business Name

OTIS ALLEN MD SC

Original Issue Date

11/15/2004

Effective Date

01/04/2022

Expiration Date

01/01/2025

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

04/03/2025