ALEXANDER STUKALOV MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

NOT RENEWED

Business

Title

First Name

ALEXANDER

Last Name

STUKALOV

Business Name

ALEXANDER STUKALOV MD

Original Issue Date

10/03/2018

Effective Date

10/03/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60610

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021