CHANG KYUN KIM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

First Name

CHANG KYUN

Last Name

KIM

Suffix

Business Name

CHANG KYUN KIM MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

EAST ST LOUIS

State

Zip

62201

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006