OTTAVIA KIMBERLY GREEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

ACTIVE

Business

Title

First Name

OTTAVIA

Middle

KIMBERLY

Last Name

GREEN

Business Name

OTTAVIA KIMBERLY GREEN MD

Original Issue Date

06/10/2024

Effective Date

06/10/2024

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/24/2026