ALBERT Y KIM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****47

License Status

NOT RENEWED

Business

First Name

ALBERT

Middle

Last Name

KIM

Business Name

ALBERT Y KIM

Original Issue Date

01/02/2014

Effective Date

01/02/2014

Expiration Date

09/30/2015

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016