NICK A VLACHOS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

First Name

NICK

Middle

Last Name

VLACHOS

Suffix

Business Name

NICK A VLACHOS MD

Original Issue Date

08/24/2005

Effective Date

08/16/2011

Expiration Date

07/31/2014

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014