MARK A BLUMENSCHEIN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****12

License Status

NOT RENEWED

Business

First Name

MARK A

Last Name

BLUMENSCHEIN

Business Name

MARK A BLUMENSCHEIN

Original Issue Date

06/05/1986

Effective Date

06/05/1986

Expiration Date

09/30/1988

City

BARRINGTON

State

Zip

60010

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005