LUCAS KYLE BUCKLEY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056785

License Status

CANCELLED

Business

Title

First Name

LUCAS

Middle

KYLE

Last Name

BUCKLEY

Business Name

LUCAS KYLE BUCKLEY MD

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2018

City

GLEN CARBON

State

Zip

62034

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

04/12/2016