DONG HO PARK Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****91

License Status

NOT RENEWED

Business

First Name

DONG

Middle

Last Name

PARK

Business Name

DONG HO PARK

Original Issue Date

09/25/2003

Effective Date

03/05/2010

Expiration Date

05/31/2012

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

07/10/2012