HENRY R KIM Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

ACTIVE

Business

First Name

HENRY

Middle

Last Name

KIM

Business Name

HENRY R KIM

Original Issue Date

08/09/2019

Effective Date

10/01/2024

Expiration Date

09/30/2027

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/16/2024