ANITA OGHOGHO IMADOMWANYI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****55

License Status

NOT RENEWED

Business

Title

DDS

First Name

ANITA

Middle

OGHOGHO

Last Name

IMADOMWANYI

Business Name

ANITA OGHOGHO IMADOMWANYI DDS

Original Issue Date

01/05/2017

Effective Date

09/28/2021

Expiration Date

09/30/2024

City

EAST SYRACUSE

State

Zip

13057

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025