JOHN YONG PARK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

CANCELLED

Business

First Name

JOHN

Middle

YONG

Last Name

PARK

Suffix

Business Name

JOHN YONG PARK MD

Original Issue Date

05/02/2000

Effective Date

05/02/2000

Expiration Date

07/31/2005

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006