TAE HO KONG DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****93

License Status

ACTIVE

Business

Title

DDS

First Name

TAE HO

Last Name

KONG

Business Name

TAE HO KONG DDS

Original Issue Date

08/11/2023

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

EAST PEORIA

State

Zip

61611

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/02/2024