CHERYL LYNN KUKICH Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****07

License Status

INOPERATIVE

Business

First Name

CHERYL

Middle

LYNN

Last Name

KUKICH

Business Name

CHERYL LYNN KUKICH

Original Issue Date

05/02/2011

Effective Date

01/08/2014

Expiration Date

03/01/2016

City

DECATUR

State

Zip

62526

County

MACON

Ever Disciplined

LastModifiedDate

07/02/2014