DAE THEODORE KWAK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

ACTIVE

Business

First Name

DAE

Middle

THEODORE

Last Name

KWAK

Suffix

Business Name

DAE THEODORE KWAK MD

Original Issue Date

07/21/2000

Effective Date

05/02/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60623

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2023