MARK J MALY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

NOT RENEWED

Business

First Name

MARK J

Last Name

MALY

Business Name

MARK J MALY

Original Issue Date

10/15/1987

Effective Date

02/07/2019

Expiration Date

01/31/2022

City

ORANGEVILLE

State

Zip

61060

County

STEPHENSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022