NATHANIEL THEODORE KOUTLAS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

ACTIVE

Business

Title

First Name

NATHANIEL

Middle

THEODORE

Last Name

KOUTLAS

Business Name

NATHANIEL THEODORE KOUTLAS MD

Original Issue Date

03/06/2024

Effective Date

03/06/2024

Expiration Date

07/31/2026

City

CHAPEL HILL

State

Zip

27599

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/06/2024