JOHN POULOS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

JOHN

Last Name

POULOS

Suffix

Business Name

JOHN POULOS MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1987

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006