THOMAS R MACHAK - Dentist License in Illinois | # 018000204

THOMAS R MACHAK

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000204

License Status

NOT RENEWED

Business

N

First Name

THOMAS

Middle

R

Last Name

MACHAK

Business Name

THOMAS R MACHAK

Original Issue Date

07/31/1987

Effective Date

07/31/1987

Expiration Date

07/30/1989

State

IL

Specialty/Qualifier

General Practice Residency

Ever Disciplined

N

LastModifiedDate

10/12/2005