DAVID R PARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

First Name

DAVID R

Last Name

PARK

Suffix

Business Name

DAVID R PARK MD

Original Issue Date

07/26/1995

Effective Date

07/26/1995

Expiration Date

07/31/2002

City

MINONK

State

Zip

61760

County

WOODFORD

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006