VINCENT ANTHONY KUCICH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

VINCENT

Middle

ANTHONY

Last Name

KUCICH

Suffix

Business Name

VINCENT ANTHONY KUCICH MD

Original Issue Date

12/31/2002

Effective Date

12/31/2002

Expiration Date

07/31/2005

City

BERWYN

State

Zip

60402

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020