PETER KYUNMYONG PARK 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

PETER

Middle

KYUNMYONG

Last Name

PARK

Business Name

PETER KYUNMYONG PARK MD

Original Issue Date

01/01/1997

Effective Date

05/19/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021