KEVIN L KUKLA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****71

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

Last Name

KUKLA

Suffix

Business Name

KEVIN L KUKLA OD

Original Issue Date

08/04/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006