JI S KIM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019026269

License Status

NOT RENEWED

Business

First Name

Middle

Last Name

KIM

Suffix

DDS

Business Name

JI S KIM DDS

Original Issue Date

09/19/2003

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

DUNLAP

State

Zip

61525

County

PEORIA

Ever Disciplined

LastModifiedDate

11/08/2006