SUEBIN PARK Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****91

License Status

ACTIVE

Business

First Name

SUEBIN

Last Name

PARK

Business Name

SUEBIN PARK

Original Issue Date

08/11/2023

Effective Date

07/06/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/06/2024