KATHLEEN M BOTTUM Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

First Name

KATHLEEN

Middle

Last Name

BOTTUM

Business Name

KATHLEEN M BOTTUM

Original Issue Date

04/26/2002

Effective Date

06/10/2020

Expiration Date

07/31/2023

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023

Case Number

2021005965

Action

Surrender (Relinquish)

Discipline Start Date

06/13/2022

Discipline Reason

controlled substance license surrendered and agree to surrender DEA Registration for cause due to inappropriately prescribing controlled substances.