CARLY FRANCES PARK DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****29

License Status

NOT RENEWED

Business

Title

DMD

First Name

CARLY

Middle

FRANCES

Last Name

PARK

Business Name

CARLY FRANCES PARK DMD

Original Issue Date

08/01/2016

Effective Date

06/15/2018

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022