SAMUEL KIM DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****52

License Status

INACTIVE

Business

Title

DDS

First Name

SAMUEL

Last Name

KIM

Business Name

SAMUEL KIM DDS

Original Issue Date

03/04/2016

Effective Date

03/04/2016

Expiration Date

09/30/2018

City

LAKE CITY

State

Zip

51449

County

STEPHENSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/15/2018