KITAE PARK Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000059

License Status

EXPIRED

Business

First Name

KITAE

Last Name

PARK

Business Name

KITAE PARK

Original Issue Date

07/13/1999

Effective Date

07/13/1999

Expiration Date

06/20/2004

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

10/13/2005