MARK HENRY HABERMEYER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019031984

License Status

NOT RENEWED

Business

First Name

MARK

Middle

HENRY

Last Name

HABERMEYER

Business Name

MARK HENRY HABERMEYER

Original Issue Date

02/14/2019

Effective Date

02/14/2019

Expiration Date

01/31/2022

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/09/2022