KALLISTA FANOULA KAMBEROS DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

ACTIVE

Business

Title

First Name

KALLISTA

Middle

FANOULA

Last Name

KAMBEROS

Business Name

KALLISTA FANOULA KAMBEROS DO

Original Issue Date

04/15/2024

Effective Date

04/15/2024

Expiration Date

07/31/2026

City

OTTAWA

State

Zip

61350

County

LA SALLE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/24/2026