MIRIAM C O'MALLEY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000617

License Status

NOT RENEWED

Business

First Name

MIRIAM

Middle

Last Name

O'MALLEY

Business Name

MIRIAM C O'MALLEY

Original Issue Date

06/24/1992

Effective Date

06/24/1992

Expiration Date

06/30/1995

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

10/12/2005