SANG TAE KIM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033125

License Status

EXPIRED

Business

First Name

SANG

Middle

TAE

Last Name

KIM

Suffix

Business Name

SANG TAE KIM MD

Original Issue Date

06/07/1995

Effective Date

06/07/1995

Expiration Date

06/30/1998

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006