SEA MI PARK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036144063

License Status

ACTIVE

Business

Title

First Name

SEA

Middle

Last Name

PARK

Business Name

SEA MI PARK MD

Original Issue Date

08/09/2017

Effective Date

04/22/2023

Expiration Date

07/31/2026

City

LAFAYETTE

State

Zip

70503

Ever Disciplined

LastModifiedDate

04/22/2023