JAE M KO - Dentist License in Illinois | # 31*****82

JAE M KO

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****82

License Status

ACTIVE

Business

N

First Name

JAE

Middle

M

Last Name

KO

Business Name

JAE M KO

Original Issue Date

10/05/2007

Effective Date

09/01/2024

Expiration Date

09/30/2027

City

CHICAGO

State

IL

Zip

60625

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

09/01/2024