MARK R HOUSKA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****02

License Status

NOT RENEWED

Business

First Name

MARK R

Last Name

HOUSKA

Suffix

DMD

Business Name

MARK R HOUSKA DMD

Original Issue Date

08/10/1987

Effective Date

08/10/1987

Expiration Date

09/30/1990

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005