DOMINIC A O'DEA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

First Name

DOMINIC A

Last Name

O'DEA

Business Name

DOMINIC A O'DEA

Original Issue Date

09/08/1995

Effective Date

09/08/1995

Expiration Date

07/31/1999

City

QUINCY

State

Zip

62301

County

ADAMS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006