JAE H KIM Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

JAE

Middle

Last Name

KIM

Business Name

JAE H KIM

Original Issue Date

12/15/2005

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

BETTENDORF

State

Zip

52722

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021