OMAR MARCUS ATA DDS 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

OMAR MARCUS

Last Name

ATA

Suffix

DDS

Business Name

OMAR MARCUS ATA DDS

Original Issue Date

09/23/1981

Effective Date

09/23/1981

Expiration Date

09/30/1984

City

CHICAGO

State

Zip

60647

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005