PHILIP DENNIS KOUSOUBRIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036159081

License Status

NOT RENEWED

Business

Title

First Name

PHILIP

Middle

DENNIS

Last Name

KOUSOUBRIS

Business Name

PHILIP DENNIS KOUSOUBRIS MD

Original Issue Date

12/30/2021

Effective Date

12/30/2021

Expiration Date

07/31/2023

City

EDEN PRAIRIE

State

Zip

55344

Ever Disciplined

LastModifiedDate

11/30/2023