KI WAN KIM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

Title

First Name

KI WAN

Last Name

KIM

Business Name

KI WAN KIM MD

Original Issue Date

05/04/2011

Effective Date

07/14/2017

Expiration Date

09/30/2020

City

EVANSTON

State

Zip

60201

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021