KITAE PARK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001067

License Status

NOT RENEWED

Business

First Name

KITAE

Last Name

PARK

Business Name

KITAE PARK

Original Issue Date

08/07/1997

Effective Date

08/07/1997

Expiration Date

06/30/1999

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

10/12/2005