RANDALL OTTO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

ACTIVE

Business

Title

First Name

RANDALL

Last Name

OTTO

Business Name

RANDALL OTTO MD

Original Issue Date

08/12/2023

Effective Date

08/12/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63131

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/12/2023