PETER S DOMAGALA DDS - Dentist License in Illinois | # 137000391

PETER S DOMAGALA DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000391

License Status

NOT RENEWED

Business

N

First Name

PETER S

Last Name

DOMAGALA

Suffix

DDS

Business Name

PETER S DOMAGALA DDS

Original Issue Date

11/21/1995

Effective Date

06/15/2015

Expiration Date

09/30/2018

State

IL

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

N

LastModifiedDate

10/31/2018