EMMANUEL K KONSTANTAKOS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

Title

First Name

EMMANUEL

Middle

Last Name

KONSTANTAKOS

Business Name

EMMANUEL K KONSTANTAKOS MD

Original Issue Date

04/20/2012

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

County

OHIO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021