GINA KIM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

NOT RENEWED

Business

First Name

GINA

Last Name

KIM

Suffix

DDS

Business Name

GINA KIM DDS

Original Issue Date

06/21/2004

Effective Date

08/24/2009

Expiration Date

09/30/2012

City

PALOS HEIGHTS

State

Zip

60465

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012