MARK A FAUGHT DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****30

License Status

NOT RENEWED

Business

First Name

MARK A

Last Name

FAUGHT

Suffix

DDS

Business Name

MARK A FAUGHT DDS

Original Issue Date

06/15/1988

Effective Date

06/15/1988

Expiration Date

09/30/1992

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005