DIMA OTAISHAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

ACTIVE

Business

Title

First Name

DIMA

Last Name

OTAISHAN

Business Name

DIMA OTAISHAN MD

Original Issue Date

05/21/2021

Effective Date

06/25/2023

Expiration Date

07/31/2026

City

MCHENRY

State

Zip

60050

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/25/2023