CLAUDIA JISUNG PARK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****76

License Status

NOT RENEWED

Business

Title

DDS

First Name

CLAUDIA

Middle

JISUNG

Last Name

PARK

Business Name

CLAUDIA JISUNG PARK DDS

Original Issue Date

04/14/2022

Effective Date

04/14/2022

Expiration Date

09/30/2024

City

BROOKLYN

State

Zip

11217

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025