VINCENT ANTHONY KUCICH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

NOT RENEWED

Business

First Name

VINCENT

Middle

ANTHONY

Last Name

KUCICH

Suffix

Business Name

VINCENT ANTHONY KUCICH MD

Original Issue Date

11/02/1999

Effective Date

11/02/1999

Expiration Date

07/31/2005

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020