LAWRENCE J KUKLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036053938

License Status

NOT RENEWED

Business

First Name

LAWRENCE J

Last Name

KUKLA

Suffix

Business Name

LAWRENCE J KUKLA MD

Original Issue Date

11/19/1976

Effective Date

06/29/2017

Expiration Date

09/30/2020

City

GALENA

State

Zip

61036

County

JO DAVIESS

Ever Disciplined

LastModifiedDate

01/14/2021