ANASTASIOS K KONSTANTAKOS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

ACTIVE

Business

Title

First Name

ANASTASIOS

Middle

Last Name

KONSTANTAKOS

Business Name

ANASTASIOS K KONSTANTAKOS MD

Original Issue Date

01/20/2012

Effective Date

07/26/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/26/2023