MICHAEL NICHOLAS POULOS DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****23

License Status

NOT RENEWED

Business

First Name

MICHAEL NICHOLAS

Last Name

POULOS

Suffix

DMD

Business Name

MICHAEL NICHOLAS POULOS DMD

Original Issue Date

01/01/1998

Expiration Date

06/01/1982

City

SKOKIE

State

Zip

60076

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005