MYOUNGSU SONG DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****75

License Status

ACTIVE

Business

Title

DMD

First Name

MYOUNGSU

Last Name

SONG

Business Name

MYOUNGSU SONG DMD

Original Issue Date

07/13/2020

Effective Date

08/30/2024

Expiration Date

09/30/2027

City

DECATUR

State

Zip

62526

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/30/2024