KENNY MATEE GOMOLPLITINANT Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****95

License Status

ACTIVE

Business

First Name

KENNY

Middle

MATEE

Last Name

GOMOLPLITINANT

Business Name

KENNY MATEE GOMOLPLITINANT

Original Issue Date

07/13/2015

Effective Date

08/19/2024

Expiration Date

09/30/2027

City

ARLINGTON HEIGHTS

State

Zip

60005

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/19/2024