SAM PARK Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021002099

License Status

ACTIVE

Business

First Name

SAM

Last Name

PARK

Business Name

SAM PARK

Original Issue Date

08/10/2004

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Pediatric Dentist

Ever Disciplined

LastModifiedDate

05/01/2024