STANLEY TAESON KIM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

NOT RENEWED

Business

First Name

STANLEY

Middle

TAESON

Last Name

KIM

Suffix

Business Name

STANLEY TAESON KIM MD

Original Issue Date

03/30/2005

Effective Date

06/28/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021