ANDREW STEPHEN BOUTSICARIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

ACTIVE

Business

Title

First Name

ANDREW

Middle

STEPHEN

Last Name

BOUTSICARIS

Business Name

ANDREW STEPHEN BOUTSICARIS MD

Original Issue Date

03/22/2024

Effective Date

03/22/2024

Expiration Date

07/31/2026

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/22/2024