THOMAS SCOTT KUKLA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****98

License Status

NOT RENEWED

Business

First Name

THOMAS SCOTT

Last Name

KUKLA

Business Name

THOMAS SCOTT KUKLA

Original Issue Date

09/17/1984

Effective Date

11/12/2015

Expiration Date

09/30/2018

City

ALGONQUIN

State

Zip

60102

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018