MARK T KLUCKA DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036077227

License Status

ACTIVE

Business

First Name

MARK T

Last Name

KLUCKA

Suffix

Business Name

MARK T KLUCKA DO

Original Issue Date

06/29/1988

Effective Date

05/16/2023

Expiration Date

07/31/2026

City

GODFREY

State

Zip

62035

County

MADISON

Ever Disciplined

LastModifiedDate

05/16/2023