MARK J AMIDEI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****26

License Status

NOT RENEWED

Business

First Name

MARK J

Last Name

AMIDEI

Suffix

DDS

Business Name

MARK J AMIDEI DDS

Original Issue Date

04/27/1999

Effective Date

04/27/1999

Expiration Date

09/30/2000

City

BEACH PARK

State

Zip

60085

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005