CHONG KWAN PARK MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036053844

License Status

INACTIVE

Business

First Name

CHONG KWAN

Last Name

PARK

Suffix

Business Name

CHONG KWAN PARK MD

Original Issue Date

11/19/1976

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

WATERLOO

State

Zip

62298

County

MONROE

Ever Disciplined

LastModifiedDate

04/07/2011