KITAE PARK - Dentist License in Illinois | # 018001067

KITAE PARK

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001067

License Status

NOT RENEWED

Business

N

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

State

IL

Specialty/Qualifier

Orthodontics

Ever Disciplined

N

LastModifiedDate

10/12/2005