STEPHANIE ANNE OTIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

ANNE

Last Name

OTIS

Suffix

Business Name

STEPHANIE ANNE OTIS MD

Original Issue Date

04/16/1998

Effective Date

04/16/1998

Expiration Date

07/31/1999

City

NASHVILLE

State

Zip

62263

County

WASHINGTON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006