DIANA SOPHIA KOLETTIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

DIANA

Middle

SOPHIA

Last Name

KOLETTIS

Suffix

Business Name

DIANA SOPHIA KOLETTIS MD

Original Issue Date

03/30/2020

Effective Date

03/30/2020

Expiration Date

07/31/2023

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023