OSSAMA I IKLADIOS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

ACTIVE

Business

Title

First Name

OSSAMA

Middle

Last Name

IKLADIOS

Business Name

OSSAMA I IKLADIOS MD

Original Issue Date

06/14/2010

Effective Date

07/09/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61606

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/09/2023