GUS THEODOS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000561

License Status

EXPIRED

Business

Title

First Name

GUS

Last Name

THEODOS

Business Name

GUS THEODOS MD

Original Issue Date

01/22/2020

Effective Date

01/22/2020

Expiration Date

07/19/2020

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Specialty/Qualifier

Cardiovascular Disease

Ever Disciplined

LastModifiedDate

11/19/2020