NICOLE YVONNE OTTENS DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049236

License Status

CANCELLED

Business

First Name

NICOLE

Middle

YVONNE

Last Name

OTTENS

Suffix

Business Name

NICOLE YVONNE OTTENS DO

Original Issue Date

07/02/2008

Effective Date

07/02/2008

Expiration Date

06/30/2010

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

Family Practice/Emergency Medicine

Ever Disciplined

LastModifiedDate

05/13/2010