JOHN W OTTEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

JOHN W

Last Name

OTTEN

Suffix

Business Name

JOHN W OTTEN MD

Original Issue Date

03/11/1997

Effective Date

03/11/1997

Expiration Date

07/31/1999

City

PEKIN

State

Zip

61555

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006