RYAN YOUNGHO PARK DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****99

License Status

NOT RENEWED

Business

Title

DMD

First Name

RYAN

Middle

YOUNGHO

Last Name

PARK

Business Name

RYAN YOUNGHO PARK DMD

Original Issue Date

05/30/2017

Effective Date

11/11/2021

Expiration Date

09/30/2024

City

LAKEWOOD

State

Zip

98498

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025