THOMAS R MACHAK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000204

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

Last Name

MACHAK

Business Name

THOMAS R MACHAK

Original Issue Date

07/31/1987

Effective Date

07/31/1987

Expiration Date

07/30/1989

City

MAYWOOD

State

Zip

60154

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005