MIRIAM GRACE KIM Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062015

License Status

EXPIRED

Business

First Name

MIRIAM

Middle

GRACE

Last Name

KIM

Business Name

MIRIAM GRACE KIM

Original Issue Date

06/25/2012

Effective Date

06/25/2012

Expiration Date

06/24/2015

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/04/2015