CHARLES MARTIN GORMAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****51

License Status

NOT RENEWED

Business

First Name

CHARLES MARTIN

Last Name

GORMAN

Suffix

DDS

Business Name

CHARLES MARTIN GORMAN DDS

Original Issue Date

09/24/1984

Effective Date

09/24/1984

Expiration Date

09/30/1986

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005

Case Number

1985000629

Action

Suspension

Discipline Start Date

06/01/1986