GENE MICHAEL KUBACKI DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

First Name

GENE

Middle

MICHAEL

Last Name

KUBACKI

Suffix

Business Name

GENE MICHAEL KUBACKI DO

Original Issue Date

01/11/2007

Effective Date

08/01/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60617

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020