KWANG KYUN CHANG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****08

License Status

NOT RENEWED

Business

Title

DDS

First Name

KWANG

Middle

KYUN

Last Name

CHANG

Business Name

KWANG KYUN CHANG DDS

Original Issue Date

08/03/2015

Effective Date

08/03/2015

Expiration Date

09/30/2018

City

MOUNT OLIVE

State

Zip

62069

County

MACOUPIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018