SANGTAE PARK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****34

License Status

NOT RENEWED

Business

Title

DDS

First Name

SANGTAE

Last Name

PARK

Business Name

SANGTAE PARK DDS

Original Issue Date

10/31/2011

Effective Date

09/10/2018

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60661

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022