JASON Y S PARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

First Name

JASON Y S

Last Name

PARK

Suffix

Business Name

JASON Y S PARK MD

Original Issue Date

07/23/2002

Effective Date

04/29/2014

Expiration Date

07/31/2017

City

IVANHOE

State

Zip

60060

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017