KITAE PARK - Dentist License in Illinois | # 136000059

KITAE PARK

Business Entity

EXPIRED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000059

License Status

EXPIRED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/13/2005