KWANGSUP S KIM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

CANCELLED

Business

First Name

KWANGSUP S

Last Name

KIM

Suffix

Business Name

KWANGSUP S KIM MD

Original Issue Date

07/14/1981

Effective Date

07/14/1981

Expiration Date

09/01/1982

City

EAST ST LOUIS

State

Zip

62201

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006