BLESSING OTOABASI GODWIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

First Name

BLESSING

Middle

OTOABASI

Last Name

GODWIN

Suffix

Business Name

BLESSING OTOABASI GODWIN MD

Original Issue Date

09/19/2018

Effective Date

09/19/2018

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021