KIA A KIM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

CANCELLED

Business

First Name

KIA A

Last Name

KIM

Suffix

Business Name

KIA A KIM MD

Original Issue Date

12/04/1992

Effective Date

12/04/1992

Expiration Date

07/31/2002

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006