OTTO LOUIS JACQUES Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

NOT RENEWED

Business

First Name

OTTO

Last Name

LOUIS JACQUES

Business Name

OTTO LOUIS JACQUES

Original Issue Date

08/20/1992

Effective Date

08/20/1992

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60301

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/26/2006