VINCENT M MARDESICH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****04

License Status

NOT RENEWED

Business

First Name

VINCENT M

Last Name

MARDESICH

Suffix

DDS

Business Name

VINCENT M MARDESICH DDS

Original Issue Date

07/17/1992

Effective Date

07/17/1992

Expiration Date

09/30/1994

City

LAKE FOREST

State

Zip

60045

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005