STATHIS J POULAKIDAS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

ACTIVE

Business

First Name

STATHIS

Middle

Last Name

POULAKIDAS

Suffix

Business Name

STATHIS J POULAKIDAS MD

Original Issue Date

09/09/1998

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

BATAVIA

State

Zip

60510

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023