DAE THEODORE KWAK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036101810

License Status

ACTIVE

Business

First Name

DAE

Middle

THEODORE

Last Name

KWAK

Suffix

Business Name

DAE THEODORE KWAK MD

Original Issue Date

01/14/2000

Effective Date

05/02/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60623

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2023