TERESA L OTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

TERESA L

Last Name

OTA

Suffix

Business Name

TERESA L OTA MD

Original Issue Date

05/28/1992

Effective Date

05/28/1992

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60625

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006