MARK ANTHONY MACAK DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

ACTIVE

Business

Title

DMD

First Name

MARK

Middle

ANTHONY

Last Name

MACAK

Business Name

MARK ANTHONY MACAK DMD

Original Issue Date

07/24/2023

Effective Date

08/29/2024

Expiration Date

09/30/2027

City

MONEE

State

Zip

60449

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/29/2024