CHI KIM LE DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****89

License Status

ACTIVE

Business

First Name

CHI

Middle

KIM

Last Name

Suffix

DMD

Business Name

CHI KIM LE DMD

Original Issue Date

04/07/2005

Effective Date

06/12/2024

Expiration Date

09/30/2027

City

ST JOSEPH

State

Zip

61873

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/12/2024