ATHANASIOS KOKKAS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****58

License Status

NOT RENEWED

Business

First Name

ATHANASIOS

Last Name

KOKKAS

Suffix

DDS

Business Name

ATHANASIOS KOKKAS DDS

Original Issue Date

06/03/2004

Effective Date

06/03/2004

Expiration Date

09/30/2006

City

GODFREY

State

Zip

62035

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006