SUNYOUNG PARK DMD Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

INACTIVE

Business

Title

DMD

First Name

SUNYOUNG

Last Name

PARK

Business Name

SUNYOUNG PARK DMD

Original Issue Date

06/20/2014

Effective Date

09/30/2022

Expiration Date

09/30/2024

City

MADISON

State

Zip

53705

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2024