ANDREW THOMAS OTTO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001762

License Status

NOT RENEWED

Business

First Name

ANDREW

Middle

THOMAS

Last Name

OTTO

Business Name

ANDREW THOMAS OTTO

Original Issue Date

02/06/2002

Effective Date

02/06/2002

Expiration Date

03/01/2004

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Ever Disciplined

LastModifiedDate

10/09/2006