MARK RICHARD BENNE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****03

License Status

NOT RENEWED

Business

First Name

MARK RICHARD

Last Name

BENNE

Business Name

MARK RICHARD BENNE

Original Issue Date

09/30/1985

Effective Date

09/30/1985

Expiration Date

09/30/1988

City

CHICAGO

State

Zip

60602

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005