MARTHA GOMOLKA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001744

License Status

NOT RENEWED

Business

First Name

MARTHA

Last Name

GOMOLKA

Business Name

MARTHA GOMOLKA

Original Issue Date

07/13/1972

Effective Date

07/13/1972

Expiration Date

09/30/1988

City

BURBANK

State

Zip

60459

County

COOK

Ever Disciplined

LastModifiedDate

10/12/2005