DAE-KEUN SONG DDS - Dentist License in Illinois | # 018001255

DAE-KEUN SONG DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001255

License Status

NOT RENEWED

Business

N

First Name

DAE-KEUN

Last Name

SONG

Suffix

DDS

Business Name

DAE-KEUN SONG DDS

Original Issue Date

10/17/2000

Effective Date

10/17/2000

Expiration Date

07/31/2001

State

IL

Specialty/Qualifier

Prosthodontics

Ever Disciplined

N

LastModifiedDate

10/12/2005