GEORGE JOHN KOULLIAS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

First Name

GEORGE

Middle

JOHN

Last Name

KOULLIAS

Suffix

Business Name

GEORGE JOHN KOULLIAS MD

Original Issue Date

11/15/2007

Effective Date

06/17/2008

Expiration Date

07/31/2011

City

PEORIA

State

Zip

61603

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

11/10/2011