KOSTANTINOS PANTELIS POULIKIDIS 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

Title

First Name

KOSTANTINOS

Middle

PANTELIS

Last Name

POULIKIDIS

Business Name

KOSTANTINOS PANTELIS POULIKIDIS MD

Original Issue Date

06/20/2018

Effective Date

06/20/2018

Expiration Date

09/30/2020

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021