PHILIP HEE GHUN SHIN DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****95

License Status

ACTIVE

Business

Title

DDS

First Name

PHILIP

Middle

HEE GHUN

Last Name

SHIN

Business Name

PHILIP HEE GHUN SHIN DDS

Original Issue Date

08/19/2015

Effective Date

08/15/2024

Expiration Date

09/30/2027

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/15/2024