JOHN W OTTEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

NOT RENEWED

Business

First Name

JOHN W

Last Name

OTTEN

Suffix

Business Name

JOHN W OTTEN MD

Original Issue Date

10/22/1986

Effective Date

10/22/1986

Expiration Date

07/31/1987

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/09/2006