NICHOLAS EARNEST POULOS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036115133

License Status

NOT RENEWED

Business

First Name

NICHOLAS

Middle

EARNEST

Last Name

POULOS

Suffix

Business Name

NICHOLAS EARNEST POULOS MD

Original Issue Date

01/20/2006

Effective Date

06/23/2020

Expiration Date

07/31/2023

City

FRONTENAC

State

Zip

63131

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

11/30/2023