DENNIS NORMAN DOMATO DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****46

License Status

NOT RENEWED

Business

First Name

DENNIS NORMAN

Last Name

DOMATO

Suffix

DMD

Business Name

DENNIS NORMAN DOMATO DMD

Original Issue Date

08/10/1994

Effective Date

08/10/1994

Expiration Date

09/30/2002

City

BROOKFIELD

State

Zip

60513

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005