ILSOON KIM DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****46

License Status

ACTIVE

Business

Title

DDS

First Name

ILSOON

Last Name

KIM

Business Name

ILSOON KIM DDS

Original Issue Date

08/04/2015

Effective Date

07/28/2024

Expiration Date

09/30/2027

City

DECATUR

State

Zip

62521

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/28/2024