LYLAN S PARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

LYLAN

Middle

Last Name

PARK

Suffix

Business Name

LYLAN S PARK MD

Original Issue Date

05/14/1999

Effective Date

05/14/1999

Expiration Date

07/31/2008

City

BATAVIA

State

Zip

60510

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008