PATRICK J O'MALLEY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****57

License Status

NOT RENEWED

Business

First Name

PATRICK

Middle

Last Name

O'MALLEY

Business Name

PATRICK J O'MALLEY

Original Issue Date

04/23/1990

Effective Date

09/20/2012

Expiration Date

09/30/2015

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016