DAVID YOUNG-SUN PARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

YOUNG-SUN

Last Name

PARK

Suffix

Business Name

DAVID YOUNG-SUN PARK MD

Original Issue Date

08/05/2002

Effective Date

08/05/2002

Expiration Date

07/31/2005

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006