MICHAEL OMAN CONNOLLY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****93

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

OMAN

Last Name

CONNOLLY

Business Name

MICHAEL OMAN CONNOLLY

Original Issue Date

10/24/2002

Effective Date

09/29/2021

Expiration Date

09/30/2024

City

PEKIN

State

Zip

61554

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025