TAE SOK KONG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****36

License Status

NOT RENEWED

Business

First Name

TAE SOK

Last Name

KONG

Suffix

DDS

Business Name

TAE SOK KONG DDS

Original Issue Date

04/30/2008

Effective Date

06/11/2009

Expiration Date

09/30/2012

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012