THEODORE M KANELLAKES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

NOT RENEWED

Business

First Name

THEODORE M

Last Name

KANELLAKES

Suffix

Business Name

THEODORE M KANELLAKES MD

Original Issue Date

01/01/1997

Effective Date

04/26/2017

Expiration Date

09/30/2020

City

JOLIET

State

Zip

60431

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021