RICHARD Y KIM Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****38

License Status

ACTIVE

Business

First Name

RICHARD

Middle

Last Name

KIM

Business Name

RICHARD Y KIM

Original Issue Date

10/22/2019

Effective Date

08/05/2024

Expiration Date

09/30/2027

City

KANKAKEE

State

Zip

60901

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/05/2024