MARK A KOSTKO DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****17

License Status

NOT RENEWED

Business

First Name

MARK A

Last Name

KOSTKO

Suffix

DDS

Business Name

MARK A KOSTKO DDS

Original Issue Date

11/14/1996

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

WHEATON

State

Zip

60187

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009