STEPHANIE ANNE OTIS MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036097671

License Status

INACTIVE

Business

First Name

STEPHANIE

Middle

ANNE

Last Name

OTIS

Suffix

Business Name

STEPHANIE ANNE OTIS MD

Original Issue Date

04/15/1998

Effective Date

04/15/1998

Expiration Date

07/31/2002

City

TOWN & COUNTY

State

Zip

63017

County

MISSOURI

Ever Disciplined

LastModifiedDate

10/09/2006