SAMUEL KIM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019030566

License Status

NOT RENEWED

Business

Title

DDS

First Name

SAMUEL

Last Name

KIM

Business Name

SAMUEL KIM DDS

Original Issue Date

03/04/2016

Effective Date

08/29/2018

Expiration Date

01/31/2022

City

LAKE CITY

State

Zip

51449

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/09/2022