GRACE LEE PARK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036119920

License Status

ACTIVE

Business

First Name

GRACE

Middle

LEE

Last Name

PARK

Suffix

Business Name

GRACE LEE PARK MD

Original Issue Date

01/04/2008

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

04/06/2023