NICHOLAS EARNEST POULOS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

First Name

NICHOLAS

Middle

EARNEST

Last Name

POULOS

Suffix

Business Name

NICHOLAS EARNEST POULOS MD

Original Issue Date

01/20/2006

Effective Date

06/23/2020

Expiration Date

07/31/2023

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023