NICK A VLACHOS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

NICK

Middle

Last Name

VLACHOS

Suffix

Business Name

NICK A VLACHOS MD

Original Issue Date

03/06/2000

Effective Date

03/06/2000

Expiration Date

07/31/2005

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

04/07/2011