EDWARD J DOMINA JR DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019015355

License Status

NOT RENEWED

Business

First Name

EDWARD J

Last Name

DOMINA JR

Suffix

DDS

Business Name

EDWARD J DOMINA JR DDS

Original Issue Date

10/07/1975

Effective Date

09/30/2015

Expiration Date

09/30/2018

State

Ever Disciplined

LastModifiedDate

10/31/2018

Case Number

1998017813

Action

Probation

Discipline Start Date

06/02/2001

Discipline Reason

Failed to pay Illinois income taxes from 1992 to 1994, the first and fourth quarters of 1996, and the first, second and third quarters of 1997.