KENNETH W PARK DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036055468

License Status

NOT RENEWED

Business

First Name

KENNETH W

Last Name

PARK

Suffix

Business Name

KENNETH W PARK DO

Original Issue Date

08/11/1977

Effective Date

07/28/2017

Expiration Date

09/30/2020

City

CARY

State

Zip

60013

County

MCHENRY

Ever Disciplined

LastModifiedDate

01/14/2021