License holder summary

Mi Kyung Kim is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Mi Kyung Kim is Lakeshore Anesthesia, P.C., 1755 Fulton Street, Suite A, Elkhart IN 46514. This licensed professional license is current. The license was granted 06/18/2010 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Mi Kyung Kim
Controlled Substance Registration - Physician
License number
01068404B
Date granted
06/18/2010
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Lakeshore Anesthesia, P.C., 1755 Fulton Street, Suite A, Elkhart IN 46514
indianalicensing.org
ID 5847965
LAST UPDATED 2024-04-12 16:20:34 UTC

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