KEUM ZA PARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

NOT RENEWED

Business

First Name

KEUM ZA

Last Name

PARK

Suffix

Business Name

KEUM ZA PARK MD

Original Issue Date

03/05/1984

Effective Date

04/18/2011

Expiration Date

07/31/2014

City

ADDISON

State

Zip

60101

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020