MICHAEL K IWAOKA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****73

License Status

NOT RENEWED

Business

First Name

MICHAEL K

Last Name

IWAOKA

Business Name

MICHAEL K IWAOKA

Original Issue Date

05/06/1988

Effective Date

05/06/1988

Expiration Date

09/30/1988

City

PEORIA HEIGHTS

State

Zip

61611

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005