KI C KIM DDS - Dentist License in Illinois | # 018001505

KI C KIM DDS

Business Entity

ACTIVE

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001505

License Status

ACTIVE

Business

N

First Name

KI

Middle

C

Last Name

KIM

Suffix

DDS

Business Name

KI C KIM DDS

Original Issue Date

09/29/2004

Effective Date

09/29/2004

Expiration Date

01/31/3004

State

IL

Specialty/Qualifier

Prosthodontics

Ever Disciplined

N

LastModifiedDate

10/12/2005