MARK A STEPHENS DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000922

License Status

ACTIVE

Business

Title

DMD

First Name

MARK

Middle

Last Name

STEPHENS

Business Name

MARK A STEPHENS DMD

Original Issue Date

07/17/2015

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Specialty/Qualifier

DEEP SEDATION AND GENERAL ANESTHESIA

Ever Disciplined

LastModifiedDate

05/02/2024