ANTIGONI KENCOS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

First Name

ANTIGONI

Last Name

KENCOS

Suffix

Business Name

ANTIGONI KENCOS MD

Original Issue Date

04/07/2003

Effective Date

04/07/2003

Expiration Date

07/31/2005

City

WATSEKA

State

Zip

60970

County

IROQUOIS

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/09/2006