JAMES N POULOS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****40

License Status

ACTIVE

Business

First Name

JAMES N

Last Name

POULOS

Business Name

JAMES N POULOS

Original Issue Date

12/03/2021

Effective Date

09/20/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60644

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/20/2024