MITCHELL DWIGHT OMORI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

NOT RENEWED

Business

First Name

MITCHELL DWIGHT

Last Name

OMORI

Business Name

MITCHELL DWIGHT OMORI

Original Issue Date

08/01/1985

Effective Date

08/20/2009

Expiration Date

09/30/2012

City

DEERFIELD

State

Zip

60015

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012