DANIEL GOMES DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****79

License Status

NOT RENEWED

Business

First Name

DANIEL

Last Name

GOMES

Suffix

DDS

Business Name

DANIEL GOMES DDS

Original Issue Date

08/20/2004

Effective Date

08/20/2004

Expiration Date

09/30/2006

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006