BRIAN G KOUKOL DDS - Dentist License in Illinois | # 019012216

BRIAN G KOUKOL DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012216

License Status

NOT RENEWED

Business

N

First Name

BRIAN G

Last Name

KOUKOL

Suffix

DDS

Business Name

BRIAN G KOUKOL DDS

Original Issue Date

07/17/1963

Effective Date

07/17/1963

Expiration Date

09/30/2002

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005