JOON YOUNG PARK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****06

License Status

NOT RENEWED

Business

Title

DDS

First Name

JOON

Middle

YOUNG

Last Name

PARK

Business Name

JOON YOUNG PARK DDS

Original Issue Date

08/17/2017

Effective Date

06/19/2018

Expiration Date

01/31/2022

City

SPRINGFIELD

State

Zip

62703

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022