THOMAS A YAMAMOTO Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001979

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

Last Name

YAMAMOTO

Business Name

THOMAS A YAMAMOTO

Original Issue Date

12/29/2015

Effective Date

12/29/2015

Expiration Date

06/30/2016

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

03/09/2017