BARBARA E OTT OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****73

License Status

NOT RENEWED

Business

First Name

BARBARA E

Last Name

OTT

Suffix

Business Name

BARBARA E OTT OD

Original Issue Date

04/11/1996

Effective Date

03/03/2020

Expiration Date

05/31/2022

City

DUNLAP

State

Zip

61525

County

PEORIA

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022