CHANSOO KIM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

CHANSOO

Last Name

KIM

Suffix

Business Name

CHANSOO KIM MD

Original Issue Date

01/01/1997

Effective Date

04/18/2011

Expiration Date

07/31/2014

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020