HEATHER L KUDUK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

Title

First Name

HEATHER

Middle

Last Name

KUDUK

Business Name

HEATHER L KUDUK MD

Original Issue Date

05/08/2014

Effective Date

06/13/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021