KEVIN MICHAEL HOMER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000936

License Status

NOT RENEWED

Business

First Name

KEVIN MICHAEL

Last Name

HOMER

Business Name

KEVIN MICHAEL HOMER

Original Issue Date

07/02/1996

Effective Date

07/02/1996

Expiration Date

06/30/1997

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005