PHILLIP S CUCULICH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043309

License Status

EXPIRED

Business

First Name

PHILLIP

Middle

Last Name

CUCULICH

Business Name

PHILLIP S CUCULICH

Original Issue Date

06/19/2001

Effective Date

06/19/2001

Expiration Date

06/18/2004

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006