OTIS GEORGE ALLEN MD Medical Doctor License verification

Business Entity

INOPERATIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

INOPERATIVE

Business

First Name

OTIS GEORGE

Last Name

ALLEN

Suffix

Business Name

OTIS GEORGE ALLEN MD

Original Issue Date

07/13/1982

Effective Date

07/20/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/20/2023