JEROME JOHN GOMOLKA Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****06

License Status

INACTIVE

Business

First Name

JEROME JOHN

Last Name

GOMOLKA

Business Name

JEROME JOHN GOMOLKA

Original Issue Date

12/07/1987

Effective Date

09/05/2018

Expiration Date

12/31/2021

City

CHICAGO

State

Zip

60641

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/30/2021