KIMBERLY ROSE KRUCZEK DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057497

License Status

CANCELLED

Business

Title

First Name

KIMBERLY

Middle

ROSE

Last Name

KRUCZEK

Business Name

KIMBERLY ROSE KRUCZEK DO

Original Issue Date

06/21/2010

Effective Date

06/21/2010

Expiration Date

06/20/2013

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/28/2010