JAI SOOK PARK MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054036

License Status

INACTIVE

Business

Title

First Name

JAI

Middle

SOOK

Last Name

PARK

Business Name

JAI SOOK PARK MD

Original Issue Date

12/21/1976

Effective Date

06/20/2011

Expiration Date

07/31/2014

City

WATERLOO

State

Zip

62298

County

MONROE

Ever Disciplined

LastModifiedDate

04/08/2014