ALAN J LICUP MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036128087

License Status

NOT RENEWED

Business

First Name

ALAN

Middle

Last Name

LICUP

Suffix

Business Name

ALAN J LICUP MD

Original Issue Date

06/10/2011

Effective Date

10/01/2020

Expiration Date

07/31/2023

City

PLEASANT PRAIRIE

State

Zip

53158

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/30/2023