JACQUELYN MICHELLE KUKULSKI DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074969

License Status

CANCELLED

Business

Title

First Name

JACQUELYN

Middle

MICHELLE

Last Name

KUKULSKI

Business Name

JACQUELYN MICHELLE KUKULSKI DO

Original Issue Date

06/24/2019

Effective Date

06/24/2019

Expiration Date

06/23/2022

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

06/13/2019