PHILLIP GEORGE KOULTOURIDES OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046009373

License Status

NOT RENEWED

Business

First Name

PHILLIP

Middle

GEORGE

Last Name

KOULTOURIDES

Suffix

Business Name

PHILLIP GEORGE KOULTOURIDES OD

Original Issue Date

07/23/2001

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

GRIFFITH

State

Zip

46319

County

INDIANA

Ever Disciplined

LastModifiedDate

09/11/2005