LEA FUCYDZY KIOUTAS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

ACTIVE

Business

First Name

LEA

Middle

FUCYDZY

Last Name

KIOUTAS

Suffix

Business Name

LEA FUCYDZY KIOUTAS MD

Original Issue Date

07/29/1996

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

HUNTLEY

State

Zip

60142

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023