SUNG KYUNG KIM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****64

License Status

NOT RENEWED

Business

First Name

SUNG KYUNG

Last Name

KIM

Business Name

SUNG KYUNG KIM

Original Issue Date

08/31/2019

Effective Date

08/31/2019

Expiration Date

01/31/2022

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022