MICHAEL PATRICK GORMAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****08

License Status

NOT RENEWED

Business

First Name

MICHAEL PATRICK

Last Name

GORMAN

Business Name

MICHAEL PATRICK GORMAN

Original Issue Date

05/14/1990

Effective Date

11/13/2015

Expiration Date

09/30/2018

City

CISSNA PARK

State

Zip

60924

County

IROQUOIS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018