MARK DOUGLAS MASE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019015222

License Status

NOT RENEWED

Business

First Name

MARK DOUGLAS

Last Name

MASE

Suffix

DDS

Business Name

MARK DOUGLAS MASE DDS

Original Issue Date

07/10/1975

Effective Date

10/01/2006

Expiration Date

09/30/2009

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/08/2010