NICOLE YVONNE OTTENS DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

ACTIVE

Business

First Name

NICOLE

Middle

YVONNE

Last Name

OTTENS

Suffix

Business Name

NICOLE YVONNE OTTENS DO

Original Issue Date

07/01/2010

Effective Date

04/28/2023

Expiration Date

07/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/28/2023