GEONWOONG PARK DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****86

License Status

ACTIVE

Business

Title

DDS

First Name

GEONWOONG

Last Name

PARK

Business Name

GEONWOONG PARK DDS

Original Issue Date

07/23/2024

Effective Date

07/23/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/23/2024