JENNIFER MARIE NOTTAGE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

Title

First Name

JENNIFER

Middle

MARIE

Last Name

NOTTAGE

Business Name

JENNIFER MARIE NOTTAGE MD

Original Issue Date

01/23/2013

Effective Date

05/08/2014

Expiration Date

07/31/2017

City

CHEYENNE

State

Zip

82001

County

WYOMING

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017