JOHN W OTTEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

First Name

JOHN W

Last Name

OTTEN

Suffix

Business Name

JOHN W OTTEN MD

Original Issue Date

04/07/1998

Effective Date

04/07/1998

Expiration Date

07/31/2005

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006