MARK A STEPHENS DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****23

License Status

ACTIVE

Business

Title

DMD

First Name

MARK

Middle

Last Name

STEPHENS

Business Name

MARK A STEPHENS DMD

Original Issue Date

10/24/2023

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2024