MARK RAY GUILLORY DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****29

License Status

CANCELLED

Business

First Name

MARK

Middle

RAY

Last Name

GUILLORY

Suffix

DDS

Business Name

MARK RAY GUILLORY DDS

Original Issue Date

10/24/2000

Effective Date

10/24/2000

Expiration Date

09/30/2004

City

GREAT LAKES

State

Zip

60088

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005