JEFFREY PARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

NOT RENEWED

Business

First Name

JEFFREY

Last Name

PARK

Suffix

Business Name

JEFFREY PARK MD

Original Issue Date

07/19/2016

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60610

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021